Unveiling Project RESET - A Bold Mission to Redefine Heart Health

Could heart disease be lurking in the shadows, silent and undetected?

While many believe that they are in relatively good health, undetected early heart disease exists in as many as one in every three Singaporeans, according to a The Lancet Regional Health Western Pacific paper published in May 2023 by a team of local researchers. A top cause of death in Singapore, Cardiovascular Disease (CVD) claims 23 lives each day – and more than one in three deaths are due to heart disease or stroke.

To halt the trajectory of heart disease in our population, a fresh, multifaceted approach is needed to bridge the gap in public education as well as on the medical front, to help discover factors and processes that can assist in identifying early stages of CVD in those who still do not showcase any symptoms.

Thus we have Project RESET - a visionary initiative aiming to revolutionise heart health awareness and intervention strategies. Launched on 27 September 2023 at the Heart Disease Prevention Symposium by Minister for Health, Mr Ong Ye Kung, this endeavour marks a pivotal moment in Singapore's healthcare landscape.

Supported by a newly awarded $25 million grant from the National Research Foundation, Singapore, and the Singapore Ministry of Health’s National Medical Research Council, Project RESET is a collaborative effort that harnesses the collective expertise and strengths of multiple institutions including public healthcare clusters and industry and community partners such as NUS Medicine, National Heart Centre Singapore (NHCS), Nanyang Technological University, Singapore (NTU Singapore) and A*STAR, to study and implement the best ways to tackle heart disease in Singapore.

Registration Criteria for Project RESET

Diving Deep to the Heart: The RESET Approach

 

The large-scale study aims to help strengthen preventive efforts by finding measurable signs of early heart disease and developing new methods to tackle them. Using the metaphor of an iceberg to elucidate the approach underpinning the study, Prof Roger Foo, Director, Cardiovascular Research Institute (CVRI), NUHCS, explained that the different factors that contribute to heart disease will be investigated by capturing a variety of data points, from lifestyle information down to genetic variations, to provide a full diagnostic picture for each individual - even those who may appear healthy – on a scale that is unprecedented in Singapore.

The ongoing five-year project will engage 10,000 participants as the research cohort, where about 3,000 participants will then be selected for a five-year follow-up programme that deploys and pilots new technologies for heart disease management.

To delve deeper into the causes of heart disease, a stringent set of inclusion criteria such as family history and presence of heart disease risk factors has also been implemented to ensure robust results.

A Heart Health Map in the Making

A silent killer in its earlier stages, did you know that up to 80% of Singaporeans may be at risk of heart disease? The arteries supplying blood to our hearts can clog up quietly and slowly, unbeknownst to us, due to factors such as unhealthy food intake, lack of physical activity and also our genetic pre-disposition - as Mr Mike Tan, a retiree, discovered when he participated in an earlier health study.

Retiree Signs Up for Project RESET after Fatty Liver Diagnosis

Mr Mike Tan, a retiree, was diagnosed with high blood cholesterol 15 years ago. While he goes to the gym three to four times a week, hikes, cycles and has taken part in half-marathons, he was more lenient towards his diet. “I have been on low dosage statin for 15 to 20 years for high cholesterol levels and my level is well controlled. It's like a security blanket,” the 64-year-old said.

Entering a previous cardiovascular-centred research study known as the NUHCS PICMAN Research Study in early 2024, Mr Tan was given a good diagnosis for his heart health, but was surprised to find out that he had fatty liver disease. Previously unaware of the condition, he learnt that fatty liver might lead to liver inflammation and scarring or hardening (cirrhosis), but is reversible if properly managed. He has since started medication to monitor the condition.

Keen to learn more about his underlying health, Mr Tan readily agreed when invited to join Project RESET, as he felt that being part of the groundbreaking research journey would enable him to contribute to meaningful advancements, as well as learn more about his own heart and metabolic health.

In line with efforts to design community spaces for better social well-being, Project RESET will be piloted at Health District @ Queenstown - an initiative designed to support residents in leading healthy and purposeful lives. Through a multi-collaborative, holistic approach, the project aims to enhance residents’ well-being through testing out preventive, science-based health interventions close to their home, before rolling out successful programmes to the rest of Singapore towards making a real-world impact.

Harnessing Technology for Health Empowerment

In the digital age, technology emerges as a helpful ally in the fight against heart disease. Project RESET embraces this ethos, leveraging innovations to make preventive health accessible to all.

To raise awareness on how there are many like Mr Tan - who may also look well on the outside yet are not exempted from heart health dangers - the Project RESET team intends to harness datasets collected to bridge current translational gaps in research, which will go towards developing effective preventive strategies in the long term.

Eligible participants in the study are equipped with digital smartwatches, tracking vital lifestyle metrics such as physical activity, stress levels, and sleep patterns. Complemented by scans and blood tests, this comprehensive approach enables researchers to better identify the clinical, biological and digital markers of heart disease. This will help to uncover the interplay between underlying conditions and heart dysfunction, and how they lead to higher risk of heart attacks and stroke, explained Prof Foo, who specified that some of these risks include blocked arteries, hypertension, fatty liver and Left Ventricular (LV) fibrosis.

As part of a Randomised Controlled Trial (RCT) to evaluate the effectiveness of digitally-supported lifestyle interventions, a sub-group of individuals will also receive health coaching via technological platforms over a one-year period. Yet, the innovation doesn't stop there. Project RESET will also leverage the use of Artificial Intelligence (AI) and immersive technologies such as the HaptGlove - a virtual reality glove - and Holotechnology, all of which will be used to carry out health discussions with participants.

These tools enables participants to feel their own liver tissue stiffness, organ sizes and heart pulse rates through touch and grip sensations, providing an experiential understanding of their body's warning signs of heart disease. Researchers hypothesise that this approach of providing a more realistic and immersive experience will have a more influential impact on motivating individuals to make beneficial lifestyle changes for their health.

Putting the Brakes on Heart Disease Progression

While the study is still in its early stages, Prof Foo shared that preliminary data already reveals out of a cohort of 100 participants studied who are aged 40 to 60, approximately half of the participants have fatty liver disease and arterial calcification – an abnormal build-up of calcium in their arteries. This shocking discovery among seemingly healthy individuals underscores the urgency for proactive interventions. Such screenings can allow for early management or treatments to reverse these health conditions, as those who gain a deeper understanding of their health will be empowered to make necessary lifestyle modifications to lead a healthier, longer life.

With each milestone, Project RESET reaffirms its commitment to empowering individuals and transforming the medical landscape, by encouraging all to take charge of their health through positive lifestyle actions and a proactive mindset, rather than responding to health crises only when they happen. As we journey towards a healthier, heartstrong Singapore, one thing becomes abundantly clear: the power to redefine health lies within each of us.