The Changi General Hospital has made testing for curable forms of hypertension more accessible and quicker for Singaporeans by leveraging the latest analytical techniques.

Its clinical laboratory with Japanese medical equipment manufacturer Shimadzu, Shimadzu-CGH Clinomics Centre (SC3), has recently started offering tests for identifying primary aldosteronism and salt-sensitive hypertension which are based on liquid chromatography with tandem mass spectrometry and AI. According to a press statement, this combination of analytical techniques offers higher analytical specificity and sensitivity and the capability to precisely measure hormone levels (particularly aldosterone and renin) in a patient’s blood sample.

WHY IT MATTERS

High blood pressure or hypertension, which is a primary cause of heart disease and stroke, affects one in three adults in Singapore, according to the Ministry of Health's latest population health survey. 

About 5% of them have the most common yet least known curable form of hypertension called primary aldosteronism. Despite the higher prevalence, many patients with this condition are not screened or treated, CGH notes. 

Moreover, about nine in ten Singaporeans are now consuming more salt than recommended in their diets, which increases the risk of developing hypertension among persons who are salt-sensitive. 

Identification therefore is key to starting treating, and eventually arresting the rise in cases of, such curable forms of hypertension, CGH stressed.

Before the establishment of SC3 in 2021, testing for curable hypertension was done abroad, "which often took several weeks for results to be ready," CGH said. With clinical tests for primary aldosteronism now available at SC3, turnaround time has been shortened to three to five days, allowing more patients to be quickly screened for and cured of treatable forms of hypertension.

Since launching the service in February this year, over 1,000 clinical tests have been conducted at SC3. 

Dr Daryl Hee, CGH senior manager and head of the SC3, disclosed their plan to secure more partnerships with public and private hospitals around Singapore to reach the wider population. In addition, the SC3, which serves as a regional reference centre, is also developing mass spectrometry solutions for diagnosing other chronic conditions in other Asia-Pacific countries.

THE LARGER TREND

Hypertension remains a largely incurable condition. However, treatments exist for managing blood pressure. Digital therapeutics is one treatment innovation that has come out in recent years. 

One player in this space, the Japanese company CureApp, has developed a hypertension DTx which has been found effective in reducing the risks of cardiovascular and cerebrovascular diseases in users. In May last year, the said app was given regulatory approval from the Japanese government, which was said to be the world's first for a hypertension DTx.

ON THE RECORD

"Some of my patients have lived with hypertension for many years before eventually undergoing aldosterone and renin testing and being diagnosed with primary aldosteronism. With access to these clinical tests at the SC3 in Singapore, doctors can now obtain accurate and prompt test results for our patients," said Troy Puar, clinical assistant professor and senior consultant of the Department of Endocrinology at CGH.

"Hopefully, this will result in more patients being screened and treated for this curable form of hypertension," A/Prof Puar, who is also the principal investigator at SC3, added.

Khoo Keow Pin, 66, is one of the patients that got recently treated for curable hypertension. For the past 15 years, he lived with hypertension without knowing that what he had was the primary aldosteronism type. He first received his consultation at CGH in June and later received his official diagnosis for the condition following testing at SC3. Last month, he underwent an adrenalectomy surgery to get his affected adrenal gland removed. For the first time after several years, his blood pressure became normal and stabilised.

"With the quick and detailed investigations done at SC3, the doctors were able to arrive at the accurate diagnosis of my type of hypertension – primary aldosteronism – enabling me to seek treatment at CGH and improve my condition," Khoo said.