Circulation: CVD events in China projected to swell by 2030

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Despite declines in tobacco use, researchers forecast that rates of cardiovascular disease (CVD) in China will swell by over one half by 2030 due to the aging population and raised rates of comorbidities, according to a study published May 4 in Circulation: Cardiovascular Quality Outcomes.

“CVD, principally stroke and coronary heart disease (CHD), is the leading cause of death and is expected to increase with further economic development and urbanization, aging of the population, and changes in diet and physical activity that will predispose many Chinese to high blood pressure, overweight, dyslipidemia and diabetes,” the authors wrote.

To help forecast the next 20 years, Andrew Moran, MD, of the Columbia University Medical Center in New York City, and colleagues projected CVD trends in China in adults aged 34 to 84 using the Coronary Heart Disease Policy Model-China—a Markov computer simulation model.

Based on recent trends, the authors predicted that the population in China will grow from the current 0.67 billion to 0.84 billion in 2030 and the number of those aged 65 or older will climb from 7 percent to 14 percent.

Between 2010 and 2030, the researchers predict that there will be 38.6 million CHD events and 129.8 million stroke incidents.

The researchers attributed these incidence rates to systolic blood pressure greater than 115 mm Hg, tobacco use and total cholesterol levels higher than 3.8 mmol/L (148 mg/dL). Combining these trends, researchers said could lead to a nearly 14 percent increase in CVD events in both men and women.

Additionally, Moran et al expect the rates of CHD and stroke will increase by over 50 percent in 2030, perhaps even as high as 74 percent.

The authors said that increases of systolic BP would have the largest effect on incidence rates of CVD events and cause 6.8 million CVD events in men, 4.2 million in women.

The researchers suggested that aggressive tobacco control--reductions of 10 or 20 percent--would lead to better outcomes. Additionally reducing BP levels by 3.6 mm Hg would decrease incidence of CVD and stroke.

“Population-wide risk reduction policies, screening for CVD risk factors, and scaling up of successful local risk factor prevention and treatment programs should be included in China’s health system reform,” the authors wrote.

“Even if other adverse risk factor trends continue unabated, national policy targeted toward aggressive tobacco control policy or blood pressure lowering could save 2.9 to 5.7 million lives during the next 20 years,” the authors concluded.