Obesity, high cholesterol and smoking are some well-known factors that can lead to heart disease.
But there is another measure that can push a group of seemingly-healthy people into the high risk category.
A screening test that measures CRP in blood can be a more accurate indicator, say doctors.
While such screening tests are not for everyone, those above the age of 40 who go for regular screening may benefit most.
Associate Professor Tai E Shyong, Senior Consultant & Head, Endocrinology, National University Hospital, said: “The Singapore recommendation is that everybody above the age of 40 should have a cholesterol measure, should have a blood pressure measure, should have a blood sugar measure.
“Then you can combine all these information to a score that tells you the chances of having a heart attack the next ten years is five per cent, 15 per cent, 20 per cent. That’s the first thing you have to do. You got to do a risk assessment. What we’re saying is that those people who’re high risk, they need treatment.
“Those people at low risk probably don’t need a drug, so there’s no decision to be made. It’s specifically the people who are in between 10 and 20 per cent. If you measure CRP, and the CRP is high, you might be a little bit more aggressive with drug therapy.”
Cholesterol drugs or statins may now be prescribed for those at moderate risk but a high CRP.
Currently, doctors prescribe such drugs known as statins to those with heart disease or who are at high risk.
Studies by European researchers suggests their risk of stroke and heart attack can be cut by about 50 per cent.
However, there are side effects to statins, such as headache, muscle pain, abdominal pain, weakness and nausea.
For this reason, Associate Professor Tai said it is not cost effective for low risk individuals to take statins to lower the risk of heart disease as the side effects may outweigh the benefits.
But he added the best prevention is still to maintain a healthy lifestyle.
“One of the things that is important to remember is that lifestyle modification can bring down CRP. In fact, one of the most effective ways to do it is to lose weight. The other thing that’s important is that, if you smoke, you got to stop smoking.”