Trends and predictions of metabolic risk factors for acute myocardial infarction: findings from a multiethnic nationwide cohort
Understanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI. The incidence and mortality contributed by metabolic...
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| Published in | The Lancet regional health. Western Pacific Vol. 37; p. 100803 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Elsevier Ltd
01.08.2023
Elsevier |
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| Online Access | Get full text |
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| Abstract | Understanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI.
The incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity.
From 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality.
The incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality.
This research was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131). The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore. |
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| AbstractList | Understanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI.
The incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity.
From 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality.
The incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality.
This research was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131). The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore. SummaryBackgroundUnderstanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI. MethodsThe incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity. FindingsFrom 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality. InterpretationThe incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality. FundingThis research was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131). The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore. Understanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI.BackgroundUnderstanding the trajectories of metabolic risk factors for acute myocardial infarction (AMI) is necessary for healthcare policymaking. We estimated future projections of the incidence of metabolic diseases in a multi-ethnic population with AMI.The incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity.MethodsThe incidence and mortality contributed by metabolic risk factors in the population with AMI (diabetes mellitus [T2DM], hypertension, hyperlipidemia, overweight/obesity, active/previous smokers) were projected up to year 2050, using linear and Poisson regression models based on the Singapore Myocardial Infarction Registry from 2007 to 2018. Forecast analysis was stratified based on age, sex and ethnicity.From 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality.FindingsFrom 2025 to 2050, the incidence of AMI is predicted to rise by 194.4% from 482 to 1418 per 100,000 population. The largest percentage increase in metabolic risk factors within the population with AMI is projected to be overweight/obesity (880.0% increase), followed by hypertension (248.7% increase), T2DM (215.7% increase), hyperlipidemia (205.0% increase), and active/previous smoking (164.8% increase). The number of AMI-related deaths is expected to increase by 294.7% in individuals with overweight/obesity, while mortality is predicted to decrease by 11.7% in hyperlipidemia, 29.9% in hypertension, 32.7% in T2DM and 49.6% in active/previous smokers, from 2025 to 2050. Compared with Chinese individuals, Indian and Malay individuals bear a disproportionate burden of overweight/obesity incidence and AMI-related mortality.The incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality.InterpretationThe incidence of AMI is projected to continue rising in the coming decades. Overweight/obesity will emerge as fastest-growing metabolic risk factor and the leading risk factor for AMI-related mortality.This research was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131). The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore.FundingThis research was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03) and National Medical Research Council Research Training Fellowship (MOH-001131). The SMIR is a national, ministry-funded registry run by the National Registry of Diseases Office and funded by the Ministry of Health, Singapore. |
| ArticleNumber | 100803 |
| Author | Nicholls, Stephen J. Hausenloy, Derek Foo, David Imran, Syed Saqib Mamas, Mamas A. Kuo, Si Min Chia, Pow Li Ho, Hee Hwa Low, Adrian F. Yeo, Tiong Cheng Huang, Zijuan Chong, Bryan Chin, Yip Han Yeo, Khung Keong Chan, Koo Hui Tan, Huay Cheem Lee, Chi Hang Sim, Hui Wen Zheng, Huili Chew, Nicholas W.S. Chua, Terrance Kong, Gwyneth Jayabaskaran, Jayanth Khoo, Deanna Goh, Rachel Chan, Mark Y. Tan, Jack Wei Chieh Lim, Patrick Kua, Jieli Lim, Toon Wei Chai, Ping Cai, Mingshi Liang, Michael Loh, Poay Huan Yip, James Liew, Boon Wah Yong, Thon Hon |
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Teck Puat Hospital, Singapore – sequence: 7 givenname: Rachel surname: Goh fullname: Goh, Rachel organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 8 givenname: Gwyneth surname: Kong fullname: Kong, Gwyneth organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 9 givenname: Yip Han surname: Chin fullname: Chin, Yip Han organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 10 givenname: Syed Saqib surname: Imran fullname: Imran, Syed Saqib organization: Khoo Teck Puat Hospital, Singapore – sequence: 11 givenname: Michael surname: Liang fullname: Liang, Michael organization: Khoo Teck Puat Hospital, Singapore – sequence: 12 givenname: Patrick orcidid: 0000-0002-0114-3957 surname: Lim fullname: Lim, Patrick organization: Khoo Teck Puat Hospital, Singapore – sequence: 13 givenname: Thon Hon surname: Yong fullname: Yong, Thon Hon organization: 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organization: Department of Cardiology, National Heart Centre, Singapore – sequence: 22 givenname: Khung Keong orcidid: 0000-0002-5457-4881 surname: Yeo fullname: Yeo, Khung Keong organization: Department of Cardiology, National Heart Centre, Singapore – sequence: 23 givenname: Derek orcidid: 0000-0003-0729-4956 surname: Hausenloy fullname: Hausenloy, Derek organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 24 givenname: Hui Wen surname: Sim fullname: Sim, Hui Wen organization: Department of Cardiology, National University Heart Centre, National University Health System, Singapore – sequence: 25 givenname: Jieli surname: Kua fullname: Kua, Jieli organization: Department of Cardiology, National University Heart Centre, National University Health System, Singapore – sequence: 26 givenname: Koo Hui surname: Chan fullname: Chan, Koo Hui organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 27 givenname: Poay Huan surname: Loh fullname: Loh, Poay Huan organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 28 givenname: Toon Wei surname: Lim fullname: Lim, Toon Wei organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 29 givenname: Adrian F. surname: Low fullname: Low, Adrian F. organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 30 givenname: Ping surname: Chai fullname: Chai, Ping organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 31 givenname: Chi Hang surname: Lee fullname: Lee, Chi Hang organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 32 givenname: Tiong Cheng surname: Yeo fullname: Yeo, Tiong Cheng organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 33 givenname: James surname: Yip fullname: Yip, James organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 34 givenname: Huay Cheem surname: Tan fullname: Tan, Huay Cheem organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore – sequence: 35 givenname: Mamas A. surname: Mamas fullname: Mamas, Mamas A. organization: Institute of Population Health, University of Manchester, Manchester, UK – sequence: 36 givenname: Stephen J. surname: Nicholls fullname: Nicholls, Stephen J. organization: Victorian Heart Institute, Melbourne, Australia – sequence: 37 givenname: Mark Y. orcidid: 0000-0003-0389-7450 surname: Chan fullname: Chan, Mark Y. email: mark.chan@nus.edu.sg organization: Yong Loo Lin School of Medicine, National University of Singapore, Singapore |
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| Keywords | Metabolic risk factors Acute myocardial infarction Mortality Public health Incidence |
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| SubjectTerms | Acute myocardial infarction Incidence Internal Medicine Metabolic risk factors Mortality Public Health |
| Title | Trends and predictions of metabolic risk factors for acute myocardial infarction: findings from a multiethnic nationwide cohort |
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