The rapid growth transformation of China from a rural agrarian society to an industrial society with increased wealth has impacted the cardiovascular health of the entire population. The increasing prevalence of cardiovascular disease (CVD) and CVD risk factors mirror in some regards the disease prevalence in western industrialized countries and in other areas present unique public health issues. This article reviewed recent population surveys, reports, and clinical trials conducted in China. It was found that the prevalence of CVD and many of the risk factors such as hypertension, obesity, and diabetes contributing to disease mortality are increasing in China. However, compared with the United States, disease mortality is lower. Also, cerebrovascular disease is far more common than ischemic heart disease in China. The low prevalence of disease may suggest a reduced role of diagnostic imaging studies as compared with the US, while the increased percentage of strokes may point to the need for widely available emergent computed tomography (CT) imaging in hospitals in China. This article also discusses the occurrence of metabolic syndrome, obesity, glucose intolerance, diabetes, and their unique features in the Chinese population. Of interest, compared with the Caucasian cohort of the same body mass index (BMI), the Chinese had a higher percentage of body fat. Metabolic syndrome was found to be associated with increased cardiovascular mortality rate. With one fifth of the world's population, China can anticipate a dramatic rise, in absolute numbers, of CVD. It is imperative that national and regional programs are initiated to detect and treat the disease. Copyright © 2009 Wiley Periodicals, Inc.

Since 1958 multiple national surveys have been carried out to estimate the prevalence of hypertension in China. With each passing decade the prevalence of hypertension rose significantly (5-11%, 7.7%, 11%, and 24-27%, respectively for 1958, 1979-1980, 1991 and 2000). An obvious trend emerged in the 1980s that prevalence increases from southern (23%) to northern (33%) parts of China. A then popular concept that prevalence of hypertension is lower in rural area of China due to poor living conditions no longer held true. Urbanization and industrialization are rapidly catching up in the rural areas as well. Interestingly, the northern Liaoning province (considered to be rural China) has a hypertension awareness of 27%. It is significantly lower than the Chinese national rates of 43% and U.S. national rate of 73%. The combination of low education along with sedentary lifestyle and prevalence of a diet rich in salt and fat predispose the rural population to a high risk for hypertension. Furthermore, there is a significantly higher relative risk for stroke in Chinese hypertensive patients than Caucasian. A 5mmHg increase in blood pressure increases the risk of coronary heart disease by 27% and stroke by 46% in Chinese and Japanese populations. By treating 1000 hypertensive patients for 5 years, one could prevent 39 strokes, 59 major cardiovascular complications and 55 deaths. Promoting public awareness of hypertension and healthy life style choices (especially in rural areas of China) should be on the top of China's public health agenda.