The Burden of Cardiovascular Disease in China: Incidence Estimates From National Surveillance (2023)

Cardiovascular diseases (CVD) continue to be a leading global public health challenge, with a substantial burden in China. A comprehensive understanding of CVD incidence among the Chinese is critical for optimizing health care resource allocation and address the CVD epidemic.

This study aimed to profile the epidemic status of CVD incidence in China based on the national population-based CVD surveillance data.

The study used data from the China CVD Surveillance System, which covered 400 districts across 31 provinces. Incident events comprised coronary heart disease and stroke. Age-standardized incidence rates were calculated using the 2001 WHO World Standard Population (WSR) and the 2020 Seventh Chinese National Census population (CSR).

A total of 944,984 incident CVD events aged ≥18 years (58.9% male, mean age 69.7 years) were included from 262 sites. In 2023, the estimated crude CVD incidence rate was 620.33 per 100,000, with age-standardized rates of 526.24 (WSR) and 635.81 (CSR). The crude incidence rates were 490.96 per 100,000 for stroke and 129.38 per 100,000 for coronary heart disease; the WSRs were 416.11 and 110.14 per 100,000, respectively, and the CSRs were 513.28 and 137.16 per 100,000, respectively. Men had significantly higher incidence rates of CVD and its subtypes than females, except for subarachnoid hemorrhage (all P < 0.001). The CVD incidence rate demonstrated an age-dependent increase (P_trend = 0.011), with a particularly pronounced elevation observed for ages ≥55 years. The crude incidence rates for CVD were notably higher in rural than in urban areas (719.38 vs 550.60 per 100,000; P < 0.001). The crude CVD incidence rate was higher in western (639.68/100,000) and central (630.18/100,000) China than in eastern China (612.25/100,000), whereas age-standardized rates were elevated in the eastern and central regions (all P < 0.001). The CVD incidence rate appeared to vary by calendar month, with a peak occurring from January to March.

This study revealed a substantial incident burden of CVD in China. Elevated incidence rates were particularly observed among male and elderly subgroups, with significant geographic disparities and seasonal variations in incidence. Targeted policies and precise public health programs are needed to mitigate these disparities and reduce the national disease burden.