A 20-year rise in cardiovascular disease (CVD) in China appears to have been spurred largely by increases in high blood pressure, according to a study from Harvard T.H. Chan School of Public Health. Increasing body mass index (BMI), decreasing physical activity, a high prevalence of smoking, and unhealthy diet have also contributed to the growing burden of CVD—now the leading cause of death in China.

This is the first large study to analyze a wide range of dietary, lifestyle, and metabolic risk factors that may be impacting CVD burden in China. The authors suggested that major changes in Chinese society—including a dramatic shift from a traditional to a more “Western” diet and lifestyle and rapid urbanization and industrialization—may have contributed to the jump in cardiovascular diseases, such as heart attack and stroke. These changes have been accompanied by marked increases in high cholesterol, obesity, and type 2 diabetes among the Chinese population.

The study was published August 15, 2016 in Journal of the American College of Cardiology.

“We described trends from 1991 to 2011 in dietary and other lifestyle risk factors for CVD in China and projected how these trends might play out from 2011 to 2031,” said Yanping Li, research scientist in the Department of Nutrition at Harvard Chan School and lead author of the study. “Our estimates suggest that the continued rise in high blood pressure, an increasingly sedentary lifestyle, increasing obesity, and worsening dietary trends will add millions of new cases of heart attacks and stroke over the next two decades.”

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