Author + information
- Received March 13, 2019
- Revision received April 16, 2019
- Accepted April 22, 2019
- Published online June 17, 2019.
- Xin Du, MD, PhDa,b,c,
- Anushka Patel, MBBS, SM, PhDc,
- Craig S. Anderson, MD, PhDb,c,d,
- Jianzeng Dong, MDa,e and
- Changsheng Ma, MDa,∗ ()
- aBeijing Anzhen Hospital, Capital Medical University, Beijing, ChinaBeijing Anzhen Hospital, Capital Medical University, Beijing, China
- bHeart Health Research Center, Beijing, ChinaHeart Health Research Center, Beijing, China
- cThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, AustraliaThe George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- dThe George Institute for Global Health China at Peking University Health Science Center, Beijing, ChinaThe George Institute for Global Health China at Peking University Health Science Center, Beijing, China
- eThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, ChinaThe First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
- ↵∗Address for correspondence:
Dr. Changsheng Ma, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China.
• The burden of CV disease is high while the health care system is weak in China.
• The pyramid of the Chinese health care system is inverted, which is not sustainable.
• Population-level strategies, primary care strengthening, and tertiary care reforms are urgently needed in China.
The burden of cardiovascular (CV) disease is very high in China, due to highly prevalent and poorly controlled risk factors resulting from changing sociodemographic structure and lifestyles in its large population. Rapid economic development and urbanization have been accompanied by changing patterns, expression, and management of CV disease. However, the health care system in China lacks a hierarchical structure, with a focus on treating acute diseases in hospital while ignoring long-term management, and primary health care is too weak to effectively control CV risk factors. To address these challenges, the Chinese central government has ensured health is a national priority and has introduced reforms that include implementing policies for a healthy environment, strengthening primary care, and improving affordability and accessibility within the health system. Turning the inverted pyramid of the health care system is essential in the ongoing battle against CV disease.
This study was supported by the National Key Research and Development Program of China (2016YFC0900901, 2016YFC1301002), and a grant from the National Natural Science Foundation of China (81530016). Dr. Anderson has received grant support from the National Health and Medical Research Council (NHMRC) of Australia; has received grant support from Takeda paid to his institution; and has received Advisory Board fees from Amgen and Boehringer Ingelheim. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received March 13, 2019.
- Revision received April 16, 2019.
- Accepted April 22, 2019.
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