Why the study?
Despite numerous studies on evolving CVD epidemiology in China, comprehensive reviews synthesizing these findings and analyzing their interrelationships were lacking.
This review highlights that while primary prevention has reduced haemorrhagic stroke mortality in China, improvements in ischaemic heart disease and ischaemic stroke mortality are primarily driven by better medical care rather than prevention.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The information summarized in this review provides a complete picture of cardiovascular disease epidemiology in Asia, highlighting specific requirements for the development of localized cardiovascular disease prevention strategies and research, and may illuminate not only the current but also future challenges faced by different Asian countries.”
“Our estimates suggest that the continued rise in high blood pressure, an increasingly sedentary lifestyle, increasing obesity, and worsening dietary trends will add millions of new cases of heart attacks and stroke over the next two decades.”
“China is facing a rising epidemic of cardiovascular disease and it shows no sign of abating. It's imperative to continue to monitor the problem, which has serious social and economic consequences. Prevention of chronic diseases through promoting healthy diet and lifestyle should be elevated to a national public policy priority.”
Intensified primary prevention is needed to counter worsening risk factors in China; extends prior Asian epidemiology by separating prevention and care contributions to mortality reductions.
Cardiovascular disease (CVD) has remained a predominant cause of mortality in China for several decades, experiencing notable epidemiological transitions. Numerous recent studies have provided valuable observational data on the evolution of CVD epidemiology across various dimensions. However, there is a paucity of comprehensive reviews that synthesize these findings and analyse their interrelationships. To address this gap, this review summarizes the key features from complex data presented in various literature reports and additional analyses of available databases. The impact of the primary drivers of these changed features and their intricate interconnections on total CVD and major subtypes, including ischaemic heart disease (IHD), ischaemic stroke (IS), and haemorrhagic stroke (HS), was quantitatively evaluated across different periods from 1990 to 2021. Four prominent transitional features of CVD mortality and the impact of underlying drivers elucidate not only new challenges for CVD prevention and control but also highlight the hidden effects of national efforts on CVD prevention. The analysis also indicated that despite a similar pattern in age-specific mortality for HS, IS, and IHD over the past decade, only the decline in HS mortality was largely attributed to the benefits of primary CVD prevention. In contrast, the declining age-specific IHD and IS mortality was due to reduced fatal events from improved medical care. The implications of these evolving features of CVD over time for further decision-making in CVD prevention strategies are discussed in depth.
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Qi et al. (2025) conducted a review in Cardiovascular disease.
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