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. 2009 Sep 9;32(9):491–497. doi: 10.1002/clc.20605

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

Yixiu Zheng 1,✉, Richard Stein 2, Tak Kwan 1,2, Christine Yu 3, Joanne Kwan 4, Chen Shao‐liang 5, Dayi Hu 6
PMCID: PMC6653363  PMID: 19743493

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. Copyright © 2009 Wiley Periodicals, Inc.

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References

  • 1. Wu Z, Yao C, Zhao D, et al. Sino‐MONICA Project: a collaborative study on trends and determinants in cardiovascular diseases in China, part I: morbidity and mortality monitoring. Circulation 2001; 103: 462–468. [DOI] [PubMed] [Google Scholar]
  • 2. Wu Z, Yao C, Zhao D, et al. Cardiovascular disease risk factor levels and their relations to CVD rates in China‐result of Sino‐MONICA Project. Eur J Cardiovasc Prev Rehabil 2004; 11: 275–283. [DOI] [PubMed] [Google Scholar]
  • 3. Wu ZS, Yao CH, Chen DY, et al. The Sino‐MONICA Beijing Study: Report on results between 1984 and 1986. Acta Med Scand 1998; (suppl 728): 60–66. [DOI] [PubMed] [Google Scholar]
  • 4. Gu G, Gupta A, Muntner P, et al. Prevalence of cardiovascular disease risk factor clustering among the adult population of China. Results from the International Collaborative Study of Cardiovascular Disease in Asia (InterAsia). Circulation 2005; 112: 658–665. [DOI] [PubMed] [Google Scholar]
  • 5.People's Republic of China‐United States Cardiovascular and Cardiopulmonary Epidemiology Research Group. An epidemiological study of cardiovascular and cardiopulmonary disease risk factors in four populations in the People's Republic of China. Baseline report from the PRC‐USA Collaborative Study. Circulation 1992; 85: 1083–1096. [DOI] [PubMed] [Google Scholar]
  • 6. Wu Y, Liu X, Li X, et al; for the PRC‐USA Collaborative Study of Cardiovascular and Cardiopulmonary Epidemiology Research Group and the China Multicenter Collaborative Study of Cardiovascular Epidemiology Research Group. Estimation of 10‐year risk of fatal and nonfatal ischemic cardiovascular diseases in Chinese adults. Circulation 2006; 114: 2217–2225. [DOI] [PubMed] [Google Scholar]
  • 7. Liu J, Hong YL, D'Agostino RB, et al. Predictive value for the Chinese population of the Framingham CHD risk assessment tool compared with the Chinese Multi‐provincial Cohort Study. JAMA 2004; 291: 2591–2599. [DOI] [PubMed] [Google Scholar]
  • 8. Critchley J, Liu J, Zhao D, Wei W, Capewell S. Explaining the increase in coronary heart disease mortality in Beijing between 1984–1999. Circulation 2004; 110: 1236–1244. [DOI] [PubMed] [Google Scholar]
  • 9. Yao C, Wu Z, Wu Y. The changing pattern of CV diseases in China. World Health Statistics Quart 1993; 46: 113–118. [PubMed] [Google Scholar]
  • 10. Wang Y, Mi J, Shan XY, Wang QJ, Ge KY. Is China facing an obesity epidemic and the consequences? The trends in obesity and chronic disease in China. Int J Obesity 2007; 31: 177–188. [DOI] [PubMed] [Google Scholar]
  • 11. Zhang L, Yang J, Hong Z, et al; for the Collaborative Group of China Multicenter Study of Cardiovascular Epidemiology. Proportion of different subtypes of stroke in China. Stroke 2003; 34: 2091–2096. [DOI] [PubMed] [Google Scholar]
  • 12. Chang CJ, Wu C, Chang CS, et al. Low body mass index but high percentage of body fat in Taiwanese subjects: implications of obesity cutoffs. Int J Obesity 2003; 27: 253–259. [DOI] [PubMed] [Google Scholar]
  • 13. He M, Tan KCB, Li ETS, Kung AWC. Body fat determination by dual energy X‐ray absorptiometry and its relation to body mass index and waist circumference in Hong Kong Chinese. Int J Obesity 2001; 25: 748–752. [DOI] [PubMed] [Google Scholar]
  • 14. Zhou B. Cooperative meta‐analysis group of the working group on obesity in China. Predictive values of body mass index and waist circumference for risk factors of certain related diseases in Chinese adults‐study on optimal cut‐off points of body mass index and waist circumference in Chinese adults. Biomed Environ Sci. 2002; 15: 83–86. [PubMed] [Google Scholar]
  • 15. Wildman RP, Gu D, Reynolds K, Duan X, Wu X, He J. Are waist circumference and body mass index independently associated with cardiovascular disease risk in Chinese adults? Am J Clin Nutr 2005; 82: 1195–1202. [DOI] [PubMed] [Google Scholar]
  • 16. Li G, Chen X, Jang Y, et al. Obesity, coronary heart disease risk factors and diabetes in Chinese: an approach to the criteria of obesity in the Chinese population. Obesity Reviews 2002; 3: 161–172. [DOI] [PubMed] [Google Scholar]
  • 17. Li G, Hu Y, Pan X. Prevalence and incidence of NIDDM in Da Qing City. Chin Med J 1996; 109(8): 599–602. [PubMed] [Google Scholar]
  • 18. He Y, Jiang B, Wang J, et al. BMI versus the metabolic syndrome in relation to cardiovascular risk in elderly Chinese individuals. Diabetes Care 2007; 30: 2128–2134. [DOI] [PubMed] [Google Scholar]
  • 19. Zhou B, Wu Y, Yang J, Li Y, Zhang H, Zhao L. Overweight is an independent risk factor for cardiovascular disease in Chinese populations. Obesity Reviews 2002; 3: 147–156. [DOI] [PubMed] [Google Scholar]
  • 20. Thomas GN, Chook P, Qiao M, et al. Detelerious impact of “high normal” glucose levels and other metabolic syndrome components on arterial endothelial function and intima‐media thickness in apparently healthy Chinese subjects: The CATHAY study. Arterioscler Thromb Vasc Biol 2004; 24: 739–743. [DOI] [PubMed] [Google Scholar]
  • 21. Ko GT, Chan JC, Cockram CS. Age, body mass index and 2‐hour plasma glucose are the major determinants of blood pressure in Chinese women newly diagnosed to have glucose intolerance. Int J Cardiol 1999; 69: 33–39. [DOI] [PubMed] [Google Scholar]
  • 22. Gu D, Reynolds K, Duan X, et al; for the InterASIA Collaborative Group. Prevalence of diabetes and impaired fasting glucose in the Chinese adult population. Diabetologica 2003; 46: 1190–1198. [DOI] [PubMed] [Google Scholar]
  • 23. Thomas GN, Schooling CM, McGhee SM, et al; for the Hong Kong Cardiovascular Risk Factor Prevalence Study Steering Committee. Metabolic syndrome increases all‐cause and vascular mortality: the Hong Kong Cardiovascular Risk Factor Study. Clin Endocrin 2007; 66(5): 666–671. [DOI] [PubMed] [Google Scholar]

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