Sudden Cardiac Death

21 Jul 2008

Question No:  633  

Question

Name of the Person: Ms Irene Ng Phek Hoong

To ask the Minister for Health (a) whether there has been any pattern of sudden cardiac deaths afflicting Singaporeans over the last 10 years; (b) what can be done to reduce the incidence occurring in the general public; and (c) how does the percentage and rate of sudden cardiac deaths in Singapore compare to that of other countries.

Reply

Reply From MOH

1 Sudden cardiac death, SCD, is a sudden and unexpected death due to cardiac causes.  For example, a common cause of SCD is abnormal heart rhythm, resulting in the heart stop pumping.

2 In Singapore, about 16,000 deaths occur every year, of which 23% are from cardiac causes.  SCD is a subset of cardiac deaths and in Singapore accounts for about a third of deaths due to cardiac causes.

3 Over the past 10 years, our incidence of SCD has increased steadily from 26 per 100,000 population in 1998 to 34 in 2007.   This is largely due to the steady increase in the proportion of the elderly in our population as the incidence of SCD is highest among the elderly.  For example in 2007, the incidence of SCD ranged from 2 per 100,000 for those below 35 years’ old to 211 for those above 60. 

4 Of the 1538 cases of sudden cardiac deaths in 2007, 67% were above 60 years of age. Less than 3% were below 35.  In fact, the incidence in younger persons under 35 has declined from 4 per 100,000 in 1998 to 2 in 2007.  There is a gender difference in the SCD incidence, with men having more than double the risk as compared to women.

5 Overall, our SCD incidence of about 1 in 3000 is low as compared to other developed countries. Studies from the US and Europe have reported higher rates, of 1 in 600 and 1 in 1250 respectively, although there are some variations in defining SCD in these studies.

6 How to reduce SCD incidence?  More than 80% of SCD is due to blockage in the coronary arteries. The key to prevention therefore lies in adoption of a healthy lifestyle: eating wisely, not smoking, staying active and maintaining healthy weight. Early detection and good management of chronic diseases like diabetes, high blood pressure and high cholesterol also reduce the risk of developing coronary heart disease.

7 For the younger age group, diseases of the heart muscles, although uncommon, may play a role in some cases of sudden cardiac death. Some examples are enlargement of heart muscles and viral infection of the heart.  Screening may be useful to detect some of these conditions so that precautionary measures can be instituted to prevent exercise-related deaths, but no test can identify all individuals at risk.

8 Despite our best efforts at prevention, sudden cardiac arrests will still occur. In such cases, survival can be improved if the patient is treated as soon as possible with cardiopulmonary resuscitation (CPR) and defibrillation.  There are programmes in place to teach and encourage CPR and use of defibrillators for the public and appropriate personnel such as policemen, and staff at sports facilities and airports. All our SCDF ambulances are equipped with defibrillators. We also support efforts to improve access to defibrillators at public locations with high human traffic and at mass participation high intensity sports events.