Smoking and physical inactivity increase risk of heart disease, shown in research study by CADENCE

• A research study, Al4HealthyCities-Singapore (Al4HealthyCities-SG), led by the Cardiovascular Disease National Collaborative Enterprise (CADENCE) in partnership with the Novartis Foundation’s Al4HealthyCities initiative, found that smoking and physical inactivity are major contributors to cardiovascular disease risks among Singaporeans.

• In Singapore, heart disease remains a top cause of death. On average, 34 people have heart attacks and 24 people die from cardiovascular disease daily. With a rapidly ageing population, these numbers are expected to increase. In particular, atherosclerotic cardiovascular diseases (ASCVD) are increasingly becoming a global health challenge. ASCVD in Southeast Asia is also reported to manifest at a younger age, with 64% of patients being under the age of 65.

• In the next phase of the study, CADENCE plans to work closely with its network partners from the public healthcare institutions and the community to map out potential intervention strategies at population level to encourage community-wide initiatives that promote healthier lifestyle habits, increased physical activity, improved dietary choices and smoking cessation programmes.

Findings from a research study, Al4HealthyCities-SG, led by CADENCE in partnership with the Novartis Foundation’s Al4HealthyCities initiative, found that smoking and physical inactivity are major contributors to cardiovascular disease risks among Singaporeans. These findings shed light on a pressing health challenge and provide crucial insights to inform targeted interventions.

Heart Disease is a leading cause of death in Singapore

Heart disease remains a leading cause of death in Singapore. On average, 34 people have heart attacks and 24 people die from cardiovascular disease daily. As the population ages, this problem is expected to worsen. Notably, atherosclerotic cardiovascular diseases (ASCVD) are increasingly affecting younger individuals in Southeast Asia, with 64% of patients under the age of 65. The situation is expected to worsen from 482 cases of heart attacks per 100,000 population in Singapore in 2025 to 1,418 per 100,000 population by 2050, representing a nearly three-fold increase.

Findings of AI4HealthyCities-SG study

The Novartis Foundation’s population health programme AI4HealthyCities harnesses data, technology, and artificial intelligence to tackle heart health inequities in urban areas. Through Singapore’s participation in the initiative led by CADENCE, the AI4HealthyCities-SG study will provide deeper insights into the drivers behind cardiovascular disease among the local population.

The study specifically examined the influence of social determinants of health (SDoH) on cardiovascular health and disease outcomes among the local population, including diabetes, acute myocardial infarction, heart failure, and overall health. SDoH are the non-medical factors that influence health outcomes, such as the environment where individuals live, and the community where they work and engage.

The study draws insights from the data of the Singapore Multi-Ethnic Cohort Phase 1 (MEC1) study, which examined the risk of cardiovascular disease among participants of Chinese, Indian, and Malay descent over several years. Aside from the MEC1 dataset, the Singapore data analysts on the AI4HealthyCities-SG study are also examining datasets from the Singapore Myocardial Infarction Registry (SMIR) which tracks the incidence of heart attack cases in Singapore, the Singapore Cardiac Longitudinal Outcome Database (SingCLOUD) Study, a research project initiated by National Heart Centre Singapore (NHCS), and the National Diabetes Database.

The analysis highlighted that interventions specifically targeting smoking and low physical activity have the most significant impact on lowering the risk of CVD. This partially mediates the impact of education, housing, and income on cardiovascular outcomes.

Strategies for a future-ready healthcare system

As part of the study, CADENCE will look towards leveraging technology to enhance clinical research, evidence-based decision-making, and care delivery while empowering individuals to adopt healthier lifestyles. By implementing proactive interventions in preventive healthcare, the population can take control of their health, resulting in longer and healthier lives.

In the next phase of the study, CADENCE plans to collaborate with public healthcare institutions and the community to develop intervention strategies at several community-wide initiatives to promote and encourage healthier lifestyle habits, increased physical activity, improved dietary choices, and smoking cessation programmes.

The AI4HealthyCities-SG study aims to serve as a regional blueprint by informing other nations about effective interventions that positively impact population health, by tapping into insights from this research.

“By designing a population health system with care integration at its core, we aim to leverage AI-driven insights to transform our approach into one that is proactive, predictive and preventive. As Singapore’s healthcare system transitions to one that supports the local population in making healthier life choices, this improves clinical care delivery, empowers patients and improves health outcomes,” said Prof Derek Hausenloy, Executive Director, CADENCE.

“As the first Asian country under the umbrella of AI4HealthyCities, we hope to be a regional blueprint that will help other nations make informed decisions about how to target health resources towards interventions that can positively impact population health,” Prof Hausenloy added.

“The Novartis Foundation is excited to support Singapore's vision for better heart health through our cardiovascular population health initiative AI4HealthyCities. In close collaboration with a consortium of academic partners under the lead of CADENCE, AI4HealthyCities leverages the country’s excellent data ecosystem and advanced analytics capabilities to identify the strongest drivers of cardiovascular health. Our goal is to inform predictive, proactive, and preventative population health roadmaps to address risk factors with precise interventions and further promote Singapore’s transition from care to health,” said Dr Ann Aerts, Head of Novartis Foundation.

About CADENCE

Established in February 2023, the Cardiovascular Disease National Collaborative Enterprise (CADENCE) is a national clinical translational programme aimed at synergising cardiovascular research and technology capabilities across Singapore.

Its goal is to integrate existing research capabilities, and bring together the strongest basic, clinical, and translational talent and expertise across Singapore and institutions, to establish a focused and impactful national cardiovascular disease research and translational programme with world-class peaks of excellence.

To achieve this, CADENCE has established four national joint platforms focused on data science, clinical trials, and artificial intelligence/digital health, together with a business intelligence and development unit to attract industry collaborations/external investments.

CADENCE is a programme of the Consortium for Clinical Research and Innovation, Singapore ↗ (opens in new tab) (CRIS). CADENCE is supported by the Singapore Ministry of Health through the National Medical Research Council (NMRC) Office, MOH Holdings Pte Ltd under the NMRC RIE2025 National Clinical Translational Programme Funding Initiative (MOH-001277).

For more information, please visit https://cadence-cvd.sg ↗ (opens in new tab)

For media inquiries, please contact:

Charlene Tan
Manager, Corporate Communications
Consortium for Clinical Research and Innovation, Singapore
charlene.tan@cris.sg

Trixie Teo
Senior Executive, Corporate Communications
Consortium for Clinical Research and Innovation, Singapore
trixie.teo@cris.sg