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Epidemiology of hypertension and cardiovascular disease--China experience
1Cardiovascular Institute, Chinese Academy of Medical Sciences, Beijing.
Insights
Geographic and genetic factors influence cardiovascular disease (CVD) risk in China. Dietary sodium and calcium intake are key factors in hypertension (HT) and CVD prevention.
Area of Science:
- Epidemiology
- Cardiovascular Disease Research
- Public Health
Background:
- Significant north-south disparities exist in China regarding blood pressure (BP), lipid levels, and coronary atherosclerosis prevalence.
- Hypertension (HT) prevalence is higher in urban than rural populations, and lower in high-altitude dwellers.
- Genetic factors influence BP from early childhood, with children of hypertensive parents exhibiting increased salt sensitivity.
Purpose of the Study:
- To investigate the epidemiological factors contributing to cardiovascular disease (CVD) variations across China.
- To identify dietary and genetic influences on blood pressure and CVD risk.
- To evaluate the effectiveness of community-based CVD prevention programs.
Main Methods:
- Analysis of epidemiological data on BP, lipids, and coronary atherosclerosis across different regions of China.
- Assessment of genetic influences on BP and salt sensitivity in children.
- Review of data from community control programs for CVD prevention established since 1969.
Main Results:
- Higher BP, lipid levels, and coronary atherosclerosis in northern compared to southern China.
- Dietary factors (higher Na/Na-K ratio, lower protein/Ca) in the north contribute to north-south differences.
- Community CVD control programs in Beijing demonstrated reductions in CVD mortality and morbidity.
Conclusions:
- Geographic, genetic, and dietary factors significantly impact CVD prevalence and BP levels in China.
- Low salt intake and potentially hypoxia are associated with lower CVD prevalence in high-altitude dwellers.
- Primary prevention strategies, including sodium restriction and calcium supplementation, are effective measures for CVD prevention.
Abstract:
Epidemiological studies show higher BP level, lipid level and higher prevalence of coronary atherosclerosis and stenosis, in north than in south China. Urban populations have higher prevalence of HT than rural, high altitude dwellers usually have lower prevalence. Genetic differences start to affect BP from early childhood, children from higher BP parents are found more salt sensitive. Higher Na and Na/K, lower protein and Ca in the north, are important dietary factors in explaining north-south difference. Low prevalence of high altitude dwellers is found to be related with low salt intake, less stress perhaps also hypoxia. CVD Community control program has started since 1969, from 1969-1989, eleven such programs have been established in Beijing covering a total population of 750,000. Encouraging results in reduction of CVD mortality and morbidity rates have been obtained. Primary prevention by restriction of Na and supplementation of calcium has been tried and found to be eligible preventive measures.