Abstract
BackgroundChina will experience an overall growth and aging of its adult population in coming decades. We used a computer model to forecast the future impact of these demographic changes on coronary heart disease (CHD) in China.MethodsThe CHD Policy Model is a validated state-transition, computer simulation of CHD on a national scale. China-specific CHD risk factor, incidence, case-fatality, and prevalence data were incorporated, and a CHD prediction model was generated from a Chinese cohort study and calibrated to age-specific Chinese mortality rates. Disability-adjusted life years (DALYs) due to CHD were calculated using standard methods. The projected population of China aged 35–84 years was entered, and CHD events, deaths, and DALYs were simulated over 2000–2029. CHD risk factors other than age and case-fatality were held at year 2000 levels. Sensitivity analyses tested uncertainty regarding CHD mortality coding, the proportion of total deaths attributable to CHD, and case-fatality.ResultsWe predicted 7.8 million excess CHD events (a 69% increase) and 3.4 million excess CHD deaths (a 64% increase) in the decade 2020–2029 compared with 2000–2009. For 2030, we predicted 71% of almost one million annual CHD deaths will occur in persons ≥65 years old, while 67% of the growing annual burden of CHD death and disability will weigh on adults <65 years old. Substituting alternate CHD mortality assumptions led to 17–20% more predicted CHD deaths over 2000–2029, though the pattern of increases in CHD events and deaths over time remained.ConclusionWe forecast that absolute numbers of CHD events and deaths will increase dramatically in China over 2010–2029, due to a growing and aging population alone. Recent data suggest CHD risk factor levels are increasing, so our projections may underestimate the extent of the potential CHD epidemic in China.
Highlights
China will experience an overall growth and aging of its adult population in coming decades
We built upon the coronary heart disease (CHD) Policy Model, a computer predictive model that was initially developed for the United States,[12] adapted the model for use in China, and forecasted CHD events and disability-adjusted life years (DALYs) in Chinese adults from 2000–2029
CHD events and deaths in China, 2000–2029 For 2002, the 7,126,000 total deaths estimated from the CHD Policy Model-China for Chinese adults aged 35–84 matched the 7,126,000 deaths reported by the Global Burden of Disease Study for that year.[36]
Summary
China will experience an overall growth and aging of its adult population in coming decades. We built upon the CHD Policy Model, a computer predictive model that was initially developed for the United States,[12] adapted the model for use in China, and forecasted CHD events and disability-adjusted life years (DALYs) in Chinese adults from 2000–2029. In this baseline analysis, levels of CHD risk factors other than age [i.e., blood pressure (BP), cholesterol, body mass index (BMI), diabetes, and smoking] were held constant over time. We conducted sensitivity analyses in order to examine the impact of future demographic changes on CHD in China under variable cause-specific mortality and CHD case-fatality assumptions
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
