Cardiovascular experts at The George Institute call for effective strategy to curb CVD in China

A paper on Prevention and Control of Cardiovascular Disease in China has just been published in Circulation, and is hoping to influence China's cardiovascular disease (CVD) prevention and control programs.

The paper examined China’s socioeconomic changes which have given rise to the increasing prevalence of CVD. China’s opportunities and responses to current CVD epidemic were identified. The paper is expected to arouse public awareness of the increasing CVD burden and provide guidance to better address this challenge.

In the past few decades, China has experienced rapid economic transformations, which has led to unhealthy lifestyles and environmental changes, and aging of the population. As a consequent of these changes, the burden of non-communicable diseases (NCDs) including CVD and diabetes, has increased, such that they account for 86% of total deaths in China. Among the various NCDs, CVD is the leading cause of death, responsible for over 2.6 million deaths annually. CVD presents great challenges to the economy, healthcare system, and whole society.

Professor Yangfeng Wu, Senior Professorial Fellow at The George Institute for Global Health at Peking University Health Science Center (TGI China), first author of the paper, called for effective and sufficient actions from the national level to address the challenge.

“We have recommended four critical policy priorities to be further developed to counter the current CVD pandemic.” Professor Wu remarked, “first, the Chinese Government should take a ‘whole-of-government and whole-of-society policy’ targeting the underlying causes of CVD. Second, it is important to reform the healthcare system to accommodate the broad nature of noncommunicable diseases. Third, policy should give priority to prevention. Finally, we need to encourage research for evidence-based, low-cost, simple, sustainable, and scalable interventions.”

Among the four policy priorities mentioned above, to take a “whole-of-government and whole-of-society policy” was identified as the No. 1 priority.   

“Unhealthy lifestyles, aging, environmental pollution, disabled healthcare system, and backward policies are major factors driving the increase of CVD in China. Given the complex socioeconomic factors behind the current CVD epidemic, actions should be taken across different sectors of the society,” Professor Wu said. “You can never convince a white-collar worker sticking to his/her desk to do more outdoor activities if air pollution is heavy and they are so busy.”

Research focusing on effective implementation of prevention and control of CVD at the population level is of considerable importance. Professor Craig Anderson, Executive Director of TGI China, emphasized the critical role implementation research plays, “policy making and clinical practice on CVD prevention and control can be guided by knowledge and findings generated from these studies.”

“Unfortunately, researchers are reluctant to conduct implementation research, regarding it as ‘soft’ or ‘informal’, Professor Anderson said, “however, implementation research helps us acquire valuable experience which is far more than what we invest in. We can use the findings of such research to influence policy, and to have a real impact.”

“TGI China has conducted many studies of this kind,” Professor Anderson further remarked, “which includes the Simplified Cardiovascular Management Study (SimCard), School-based Education Program to Reduce Salt Intake in Children and Their Families (School EduSalt), China Rural Health Initiative (CRHI), and the Clinical Pathway for Acute Coronary Syndrome in China (CPACS). These studies have produced evidence for future CVD prevention and control in China and other resource-limited areas.”

It is anticipated that in the next several years, China will face an even greater challenge spearheaded by the ever-increasing CVD burden. “The control and prevention of CVD is a long-term approach. However, if the four identified policy priorities can be adopted, it is not impossible for China to contain the CVD epidemic. It will further help bring about the success of worldwide efforts to achieve sustainable CVD reduction.” Professor Wu said.