Heart Disease in China
It has long been the case that heart disease was described as the leading cause of death in the western world. A new study released today by the New England Journal of Medicine reveals that the disclaimer is no longer necessary.
The study reports that disease of the heart has become the leading cause of death within China. Data from 1957 for China had put diseases of the heart in a firm fifth place amongst causes of mortality. The rapid increase in heart disease should ring alarm bells for the government of China, which has hitherto been focused upon the control of infectious diseases.
The current study was conducted on 169,871 men and women, whose data (demographic characteristics, medical history, lifestyle-related risk factors etc.) were obtained in 1991, by means of a standard protocol used to identify a representative sample of the general Chinese population. Of these, 158,666 (93.4%) were identified and interviewed in 1999 and 2000, as part of the follow-up study. Information was obtained on their history of disease, hospitalizations or death, by means of hospital records and/or death certificates.
The research team led by Dr. Jiang He, of the University of Tulane, New Orleans, aimed to identify the major causes of death and the modifiable risk factors for death. During an average follow-up period of 8.3 years (1,239,191 person-years), scientists discovered there were 20,033 deaths, a total mortality of 1345.2 per 100,000 person-years. The three leading causes of death among men were cancer, heart disease and cerebrovascular disease, while for women, the number one cause of death was heart disease, followed by cerebrovascular disease and cancer. These three leading causes of death accounted for 66% of deaths from all causes, in men and women.
Diseases of the heart were the lead cause of death in the total population, being at the root of 4,506 deaths (total mortality - 296,3 per 100,000 person-years), as compared to the second cause of death, cancer, which caused the death of 4,459 participants (total mortality of 293,3).
Hypertension was found to be the leading preventable risk factor for death among Chinese adults aged 40 or older. It is well-known that hypertension is the most common risk factor for cardiovascular and cerebrovascular diseases worldwide. "The prevention and control of hypertension could reduce the total mortality by 11.7 percent in the total study population", researchers say.
Cigarette smoking came second on the list of preventable risk factors, and scientists approximate that the total mortality could be reduced by 10.0 percent among men and by 3.5 percent among women in China if smoking could be eliminated. Smoking increases mortality from cardiovascular disease, cancer and respiratory disease.
Physical inactivity was another factor related to an increase in mortality among Chinese men and women, and so was underweight, a possible indicator of malnutrition.
All factors that bring greater risk of heart disease should be kept under control, in order to limit the number of premature deaths. Hypertension and smoking are the main ones, but physical activity and improved nutrition are important strategies as well that help prevent cardiovascular problems, researchers conclude.
The study was supported by grants from the American Heart Association, the National Heart, Lung and Blood Institute and the Chinese Academy of Medical Sciences (Beijing).
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