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Estimating the Future Burden of Cardiovascular Disease in China and the Potential Value of Universal Lipid and Blood Pressure Control

      Objectives

      Cardiovascular disease (CVD) is playing an ever-increasing role in China’s disease burden. This study estimated this burden over the next 15 years and the potential value of universal lipid and blood pressure control strategies.

      Methods

      First, we estimated the prevalence of all CVD risk factors based on recent China Health and Nutrition Surveys. Next, using epidemiological transition literature we modeled how prevalence of these conditions will evolve between 2016 and 2030. Finally, we used the Globoriskmodel to translate risk factor prevalence by age and sex subgroups into incidence of CVD events. We ran this model under different coverage scenarios for lipid and blood pressure control to ascertain potential social value net of the additional cost of treatment.

      Results

      We find that rising risk factor prevalence and population aging will lead to considerable growth in CVD burden from 2016-2030: an additional 75 million acute myocardial infarctions (AMIs), 118 million strokes, and 39 million CVD deaths. Universal treatment of hypertension and dyslipidemia patients could avert 10–20 million AMIs, 8–30 million strokes, and 3–10 million CVD deaths during the 2016-2030 period, depending on the combination of interventions used. This equates to a positive social value net of health care costs as high as $984 billion. Even if we limit the universal treatment only to a high-risk population of diabetic patients, 1.9–7.2 million AMIs, 2.2–7.4 million strokes, and 0.96–2.7 million CVD deaths could be averted, with a positive net social value as high as $480 billion during the 2016-2030 period.

      Conclusions

      In light of its aging population and epidemiological transition, China faces considerable increases in CVD morbidity and mortality. Widespread lipid and blood pressure treatment may reduce CVD burden substantially and provide substantial social value.