Trends in Cardiovascular Diseases Burden in China, 1990-2023

BACKGROUND: Cardiovascular diseases (CVDs) are the leading cause of disability and death in China. OBJECTIVES: The authors aimed to analyze the trends in the CVD burden across mainland China from 1990 to 2023 and to assess the contribution of modifiable risk factors. METHODS: We utilized data from the Global Burden of Disease 2023 analysis for mainland China, which involved estimates of overall and cause-specific health metrics for CVDs. Advanced statistical modeling and a wide array of data sources were used to evaluate the attributable burden of modifiable risk factors. RESULTS: In 2023, there were 11.1 million incident cases, 135.8 million prevalent cases, and 4.5 million deaths from all CVDs in China. CVDs with the highest incidence were lower extremity peripheral arterial disease, ischemic stroke, ischemic heart disease, intracerebral hemorrhage, and atrial fibrillation and flutter. The top contributors to disability-adjusted life years (DALYs) were ischemic heart disease, intracerebral hemorrhage, ischemic stroke, hypertensive heart disease, and subarachnoid hemorrhage. Age-standardized DALYs for CVDs significantly decreased from 10,065.7 per 100,000 population in 1990 to 4,059.3 in 2023, representing a decrease of 59.7%. The proportion of DALYs due to ischemic CVDs increased, whereas the proportion for hemorrhagic CVDs declined during 1990-2023. The 5 leading risk factors for CVDs were high systolic blood pressure, ambient particulate matter pollution, high low-density lipoprotein cholesterol, smoking, and lead exposure in 2023. CONCLUSIONS: Despite notable progress in reducing age-standardized DALYs of CVDs in China, the overall enduring burden and the rising challenge of specific risk factors highlight the urgent need for tailored public health strategies.