A local study will track healthy Singaporeans' heart health and what causes them to get metabolic diseases such as diabetes.
Scientists here are examining the genetic make-up of Singapore’s multi-ethnic population to come up with more precise treatments for Asians.
This study will follow about 1,000 healthy Singaporeans between 18 and 65 years old for two decades.
The scientists will be tracking their heart health and what causes them to get metabolic diseases such as diabetes.
They will be focusing on the interaction between genetics, lifestyle, physical activity and subsequent heart activity.
The study will start with 700 healthy volunteers and eventually follow 1,000 of them for 20 years. During that time, the volunteers will undergo periodic tests on heart rate, heart shape, calcium levels, blood pressure, diet and lifestyle. They will also wear fitness trackers.
This study comes on the heels of a recent one with 200 healthy volunteers who had to wear fitness trackers for a week. Using fitness trackers, MRI scanners and electrocardiograms, researchers found that the devices not only measured fitness but could also differentiate between certain types of heart disease.
Associate Professor Yeo Khung Keong, Senior Consultant, Department of Cardiology, the National Heart Centre Singapore (NHCS), who co-authored that study report, said the new study will build on these volunteers to reach 700 and then 1,000.
Genetic differences matter
Prof Yeo said scientists are looking for the genetic map to collect baseline data on these conditions in Asians, so that personalised treatments can be offered. Currently, most data is from Western research on Caucasians, so treatments are not especially tailored to Asians.
He said that while it is incorrect to say that Caucasian studies do not apply to Asians, and vice versa, for certain drugs and diseases, there are clear genetic diff erences between people of different ethnicities.
“It’s the same reason why some of us have lighter hair, dark hair or thin hair. These are manifestations of genetics. For instance, right now I know that the blood pressure medicine I give a patient will work for most people. But maybe I could have started the patient on a different medication that would have been perfect for that patient’s genetic profile.”
He said Singapore is a good place for the study because although the pool of volunteers may be small, research can be thorough.
“Diversity is a strength. We don’t have the luxury of a billion people in our population, so we’ll have fewer volunteers but can go into deeper detail about each of them.”
A similar genetic research project in the US has already proved invaluable, he said. “They’ve identified a gene in some patients, which resulted in extremely low cholesterol levels. This led to the development of a class of drugs [the PCSK9 inhibitors] that help lower cholesterol.”
He hopes the Singapore study can make such a breakthrough and also create targeted treatments. On a global scale, the results of the study will be significant, but it can only be successful with the support of the volunteers.
“Without their contribution, doctors basically operate on old knowledge. We need to promote a culture of participation in our own destiny. If we don’t do it, we’ll be relying on Icelanders and Americans to do it. It won’t be as relevant, and we’ll be missing an opportunity to do good in our part of the world.”
It’s not just about genes
Whatever genes you are born with, you can still beat the gene lottery by living a healthy life.
Good health is not determined by genes alone, said Prof Yeo. “We hope to show that even though you’re born with a particular set of genes, how you lead your life – namely, having a healthy lifestyle, not smoking, doing exercise, and getting plenty of sleep – can contribute to good health. You do have some degree of control. You can influence the outcome."
Exercise can help with general cardiovascular fitness and boost good cholesterol. In athletes or people who train regularly, the heart is a trained muscle, and so ismore effective.
But Prof Yeo said even overweight or obese patients who exercise regularly will generally do better than average-sized people who do not exercise at all.
The American Heart Association advises 30 to 45 minutes of moderate- or high-intensity exercise around three times a week.
Those interested to enrol in the study, which is part of the SingHEART programme, can call NHCS Biobank Coordinators at 9159-7029 during office hours (Mondays to Fridays from 8.30am to 5.30pm, excluding public holidays), or email: biobanking_enquiries@ nhcs.com.sg.