Declining age-specific mortality for haemorrhagic stroke was attributed to primary prevention, while declines in ischaemic heart disease and stroke mortality were due to improved medical care.
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.
Abstract 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.
“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.”
Qi et al. (2025) conducted a review in Cardiovascular disease. Declining age-specific mortality for haemorrhagic stroke was attributed to primary prevention, while declines in ischaemic heart disease and stroke mortality were due to improved medical care.