Evolving Cardiovascular Disease Prevalence, Mortality, Risk Factors, and the Metabolic Syndrome in China

Abstract

The rapid growth transformation of China from a rural agrarian society to an industrial society with increased wealth has impacted the cardiovascular health of the entire population. The increasing prevalence of cardiovascular disease (CVD) and CVD risk factors mirror in some regards the disease prevalence in western industrialized countries and in other areas present unique public health issues. This article reviewed recent population surveys, reports, and clinical trials conducted in China. It was found that the prevalence of CVD and many of the risk factors such as hypertension, obesity, and diabetes contributing to disease mortality are increasing in China. However, compared with the United States, disease mortality is lower. Also, cerebrovascular disease is far more common than ischemic heart disease in China. The low prevalence of disease may suggest a reduced role of diagnostic imaging studies as compared with the US, while the increased percentage of strokes may point to the need for widely available emergent computed tomography (CT) imaging in hospitals in China. This article also discusses the occurrence of metabolic syndrome, obesity, glucose intolerance, diabetes, and their unique features in the Chinese population. Of interest, compared with the Caucasian cohort of the same body mass index (BMI), the Chinese had a higher percentage of body fat. Metabolic syndrome was found to be associated with increased cardiovascular mortality rate. With one fifth of the world's population, China can anticipate a dramatic rise, in absolute numbers, of CVD. It is imperative that national and regional programs are initiated to detect and treat the disease.