刘明波
中国医学科学院阜外医院 心血管内科
BACKGROUND:Temporal trends and geographical variations in disease burden for diabetes mellitus (DM) and cardiovascular disease (CVD) attributable to high body mass index (BMI) in China have not been fully elucidated.METHODS:We estimated deaths and years of life lost (YLLs) for DM and CVD attributable to high BMI by age, sex, year, and region from 2005 to 2018 based on pooled data of 1.25 million adults.FINDINGS:Approximately 497,430 (95% uncertainty interval [UI], 470,520-525,720) deaths for DM and CVD were attributable to high BMI in China in 2018, with 453,750 deaths from CVD and 43,700 deaths from DM. Between 2005 and 2018, there was a 17.35% increase in age-standardized mortality rate for DM and CVD attributable to high BMI. The high BMI-related DM and CVD YLL rates increased from 127.46 (95% UI 108.70-148.62) per 100,000 people aged 20-24 years to 5,735.54 (95% UI 4,844.16-6,713.53) per 100,000 people aged ≥80 years, respectively. The highest age-standardized mortality rate for high BMI-related DM and CVD in northeast, northwest, and circum-Bohai Sea regions of China.CONCLUSION:The disease burden for DM and CVD attributable to high BMI increased substantially between 2005 and 2018. Urgent measures are required at both national and regional levels for resource mobilization to slow the growing burden.FUNDING:The work was supported by the National Key Research and Development Program of China, China National Science & Technology Pillar Program, and National Health Commission of the People's Republic of China.
Med (New York, N.Y.) 2023
Recent decades have seen the remarkable development of China in medical accessibility and quality index, and the application of a number of new advanced cardiovascular technologies benefits more patients. However, according to the Annual Report on Cardiovascular Health and Diseases in China published in this article, which was organized and summarized by National Center for Cardiovascular Diseases, there is still a huge population living with risk factors of cardiovascular diseases (CVD), and the morbidity and mortality of CVD are increasing. It is estimated that there are around 330 million patients suffering from CVD currently, including 245 million of hypertension, 13 million of stroke, 45.3 million of peripheral artery disease, 11.39 million of coronary heart disease (CHD), 8.9 million of heart failure, 5 million of pulmonary heart disease, 4.87 million of atrial fibrillation, 2.5 million of rheumatic heart disease, and 2 million of congenital heart disease. Tobacco use, diet and nutrition factors, physical activity, overweight and obesity, and psychological factors are what affect cardiovascular health, while hypertension, dyslipidemia, diabetes, chronic kidney disease, metabolic syndrome, and air pollution are the risk factors for CVD. In this article, in addition to risk factors for CVD, we also report the epidemiological trends of CVD, including CHD, cerebrovascular disease, arrhythmias, valvular heart disease, congenital heart disease, cardiomyopathy, heart failure, pulmonary vascular disease and venous thromboembolism, and aortic and peripheral artery diseases, as well as the basic research and medical device development in CVD. In a word, China has entered a new stage of transforming from high-speed development focusing on scale growth to high-quality development emphasizing on strategic and key technological development to curb the trend of increasing incidence and mortality of CVD.
Chinese medical journal 2023
OBJECTIVE:To quantify the change on burden of disease from hypercholesterolemia in China from 1990 to 2010.METHODS:Related data were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010). Population attributable risk was adopted to estimate the burden of disease from hypercholesterolemia.RESULTS:The death and burden of disease from hypercholesterolemia for Chinese residents increased from 98 000 and 2.237 million disability-adjusted of life years (DALY) in 1990 to 281 000 and 5.912 million DALY respectively. In 2010, 251 000 ischemic heart disease and 30 000 ischemic stroke deaths were caused by hypercholesterolemia, accounted for 3.4% (28.1/830.2) of the total deaths. In 2010, the DALY of ischemic heart disease and ischemic stroke attributed to hypercholesterolemia was 5.169 million and 0.743 million respectively. DALY was 3.356 million in male and 2.555 million in female. Years of life lost due to premature mortality (YLL) was 5.268 million, and years lived with disability (YLD) was 0.644 million.CONCLUSION:Hypercholesterolemia is a major risk factor for deaths and life loss in 2010, and the burden of disease and death from hypercholesterolemia increased obviously from 1990 to 2010 in China.
Zhonghua xin xue guan bing za zhi 2015
OBJECTIVE:To analyze the features of distribution and variation trends of mortality of ischemic heart disease over the age of 35 years old in China, 2004-2011.METHODS:A total of 493 274 cases were recruited in the study, the mortality data of the ischemic heart diseases were collected from the national disease surveillance point (DSP) system between 2004 and 2011. The change of ischemic heart disease standardized mortality was described, and the annual change percentage of age group mortality and standardized mortality were analyzed using log linear regression method.RESULTS:In 2004-2011, the standardized mortality of ischemic heart disease over the age of 35 showed an upward trend in each regions of China.In 2004, the ischemic heart disease standardized mortality over the age of 35 was 176.2/100 000 among males and 131.7/100 000 among females in urban areas, and the figures increased to 204.6/100 000 and 147.9/100 000 respectively in 2011.In 2004, the ischemic heart disease standardized mortality over the age of 35 was 164.4/100 000 among males and 122.2/100 000 among females in rural areas, and the figures increased to 236.8/100 000 and 151.5/100 000 respectively in 2011. The ischemic heart disease standardized mortality was lower in rural regions than in urban regions in 2004, but it changed to be higher in rural regions than in urban regions in 2011 both in males and female. The annual growth rate of ischemic heart disease mortality over the age of 35 was separately 5.00% in male and 3.65% in female. The annual growth rate was highest among males in rural areas (7.09%), followed by females in rural areas (5.06%). The growth rate was lowest among females in urban areas (1.69%).It was found that the increasing trends of ischemic heart disease mortality of males both in urban and rural areas, and females in rural areas was statistically significant (P < 0.05).CONCLUSION:The mortality of ischemic heart disease has still been showing an uprising trend, especially in the rural areas.
Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 2014
OBJECTIVE:To quantify the burden of disease related to high blood pressure in the Chinese population.METHODS:We used results from the Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) in China. Data for mean systolic blood pressure, burden of deaths,Years of Life Lost(YLLs), Years Lived with Disability (YLDs), disability-adjusted life years (DALYs), and relative risk were corrected for regression dilution bias to calculate the population impact fractions and estimate the attributable deaths and DALYs.RESULTS:Among all the deaths due to cardiovascular diseases and DALYs, 64.0% of them were caused by high blood pressure. In 2010, a total number of 2.043 million deaths were caused by high blood pressure, including 1.154 million males. 2.007 million deaths were due to cardiovascular diseases, 35 000 due to chronic kidney diseases. Deaths caused by high blood pressure accounted for 24.6% of all the deaths. In total, 37.94 million person-years DALYs were caused by high blood pressure, of which 23.33 million person-years were males and 14.61 million person-years were females. There were 2.365 million person-years of YLDs and 35.57 million person-years of YLLs, which both accounted for 12% of the total DALYs.CONCLUSION:Compared to the global results of GBD 160, on either deaths or DALYs, the proportion attributable to high blood pressure were quite high for a country like China. The health effects caused by high blood pressure seemed to be quite serious which called for attention.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2014
OBJECTIVE:To explore the trend and characteristics of cardiovascular disease mortality in China.METHODS:Mortality data from the National disease surveillance system from 2004 to 2010 was used. Underreporting was adjusted and trends were analyzed on the rates of crude mortality, standardized mortality and causes of death fraction among cardiovascular diseases.RESULTS:The total mortality of cardiovascular diseases increased from 240.03 to 268.92 per one hundred thousand during 2004 to 2010, with an average annual increase of 5.50 per one hundred thousand, with the annual increase of 2.17% . Data from all causes of death, ischemic heart disease, hypertensive heart disease, cerebrovascular disease, and other heart disease showed an upward trend, with the annual rise of 5.05%, 2.08%, 1.02% and 2.66% respectively while rheumatic heart disease showed a downward trend, with the declining rate of 7.02% per annum. After eliminating the effect of aging, the trend remained the same but the slope was decreasing. The proportion of national cardiovascular mortality on total deaths increased annually by 37.46% to 40.73% from 2004 to 2010. The proportion of cerebrovascular disease remained unchanging but the proportion of ischemic heart disease showed a significant increase. The proportion of rheumatic heart disease declined while the proportion of other cardiovascular disease mortality showing a slight change.CONCLUSION:In recent years, the cardiovascular mortality had significantly increased, which was mainly due to the increase of ischemic heart disease mortality.
Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 2013
Major and profound changes have taken place in China over the past 30 years. Rapid socioeconomic progress has exerted a great impact on lifestyle, ranging from food, clothing, working and living conditions, and means of transportation to leisure activities and entertainment. At the same time, new health problems have emerged, and health services are facing new challenges. Presently, cardiovascular diseases (CVD) are among the top health problems of the Chinese people, and pose a serious challenge to all engaged in the prevention and control of these diseases. An epidemic of CVD in China is emerging as a result of lifestyle changes, urbanization and longevity. Both national policy decision-making and medical practice urgently need an authoritative report which comprehensively reflects the trends in the epidemic of CVD and current preventive measures. Since 2005, guided by the Bureau of Disease Prevention of the Ministry of Health of the People's Republic of China and the National Center for Cardiovascular Diseases of China, nationwide experts in the fields of epidemiology, clinical medicine and health economics in the realms of CVD, cerebrovascular disease, diabetes and chronic kidney disease, completed the Report on Cardiovascular Diseases in China every year. The report aims to provide a timely review of the trend of the epidemic and to assess the progress of prevention and control of CVD. In addition, as the report is authoritative, representative and readable, it will become an information platform in the CVD field and an important reference book for government, academic institutes, medical organizations and clinical physicians. This publication is expected to play a positive role in the prevention and control of CVD in China. We present an abstract from the Report on Cardiovascular Diseases in China (2010), including trends in CVD, morbidity and mortality of major CVDs, up-to-date assessment of risk factors, as well as health resources for CVD, and a profile of medical expenditure, with the aim of providing evidence for decision-making in CVD prevention and control programs in China, and of delivering the most authoritative information on CVD prevention and control for all citizens.
Biomedical and environmental sciences : BES 2012
OBJECTIVE:To evaluate the effects of amlodipine-based antihypertensive combination regimen on blood pressure control and impact on cardiovascular events.METHODS:From Oct. 2007 to Oct. 2008, a total of 13 542 hypertensive patients from 180 centers in China were included in this multi-centre randomized, controlled, blind-endpoint assessment clinical trial. Inclusion criteria were: essential hypertension, 50 - 79 years of age with at least one cardiovascular risk factor and signed consent forms. Patients were randomly assigned to receive low-dose amlodipine + diuretics (group A) or low-dose amlodipine + telmisartan (group T). The primary endpoints are composite of non-fatal stroke/myocardial infarction and cardiovascular death. All patients will be followed-up for 4 years.RESULTS:The characteristics of patients between the two groups were similar: mean age (61.5 +/- 7.7) Yrs with 19% history of cerebrovascular diseases, 12% coronary diseases, 18% diabetes, 42% dyslipidemia, mean initial blood pressure 157/93 mm Hg. After 8-week treatment, mean blood pressure in group A and B were reduced to (133.0 +/- 11.0)/(81.0 +/- 7.6) mm Hg, (132.9 +/- 11.6)/(80.6 +/- 7.9) mm Hg respectively. Blood pressure control rates reached 72.1% and 72.6% in group A and T, respectively.CONCLUSION:Amlodipine-based antihypertensive combination regimens achieved satisfactory blood pressure control rate in patients with essential hypertension in this patient cohort.
Zhonghua xin xue guan bing za zhi 2009
