Drugs for preventing cardiovascular disease in China

Risk factor thresholds should vary according to resources

In China cardiovascular disease accounts for a third of total mortality and the rate is still increasing.1 The disease is potentially preventable. However, the task for primary prevention targeted at risk factors is daunting given the burden of disease and sparse healthcare resources in China. The prevalence rates of hypertension, hyperlipidaemia, diabetes, overweight including obesity, and cigarette smoking in the adult population are 18.8%, 18.6%, 2.6%, 29.9%, and 36.0% respectively.2 Healthcare policies need to be evidence based, but they should also consider what the society's needs are, whether it can afford the interventions, and whether it can make cost effective use of resources.

The overall risk strategy has been widely adopted in Western populations: all risk factors in a person are considered together and the overall cardiovascular risk informs treatment decisions.3 An important message for developing countries like China is that the new strategy is more cost effective than the old practice—more cardiovascular events can be prevented …