In June 2017, the China Cardiovascular Disease Report 2016 was released, and a summary of the report was published in the journal China Circulation. Currently, cardiovascular disease deaths account for the leading cause of total deaths in both urban and rural areas, 45.01% in rural areas and 42.61% in urban areas. The prevalence of cardiovascular disease risk factors in China is clearly trending, leading to an increase in the number of cardiovascular disease cases. The number of cardiovascular disease cases will continue to grow rapidly in the next 10 years. Overall, the prevalence of cardiovascular disease and mortality in China are still on the rise. The number of cardiovascular disease is projected to be 290 million, including 13 million strokes, 11 million coronary heart disease, 4.5 million heart failure, 5 million pulmonary heart disease, 2.5 million rheumatic heart disease, 2 million congenital heart disease, and 270 million hypertension. The mortality rate of cardiovascular disease ranks first, higher than that of tumors and other diseases, accounting for more than 40% of the death composition of the population, especially in rural areas, where the mortality rate of cardiovascular disease has continued to be higher than urban levels in recent years. The total cost of hospitalization for cardiovascular diseases is also increasing rapidly, and its average annual growth rate is much higher than the GDP growth rate from 2004 to the present. 1. cardiovascular disease deaths The cardiovascular disease mortality rate remained the highest in 2015, higher than that of oncology and other diseases. Rural cardiovascular disease mortality rates have exceeded and continued to be higher than urban levels since 2009. Figure 1 Changes in cardiovascular disease mortality among urban and rural residents in China from 1990 to 2015 In 2015, the mortality rate of cardiovascular disease in rural areas was 298.42/100,000, including 144.79/100,000 for heart disease and 153.63/100,000 for cerebrovascular disease; the mortality rate of cardiovascular disease in urban areas was 264.84/100,000, including 136.61/100,000 for heart disease and 153.63/100,000 for cerebrovascular disease. 100,000, and the death rate of cerebrovascular disease was 128.23/100,000. Cardiovascular diseases accounted for 45.01% and 42.61% of causes of death in rural and urban areas, respectively, in 2015. Two out of every five deaths were due to cardiovascular disease. Figure 2 Composition ratio of major disease causes of death in rural and urban China in 2015 (%) Age-specific cardiovascular disease mortality in China was 21% lower in 2013 than in 1990. Cerebrovascular disease was the leading cause of death for both men and women in China, with a 28.8% increase in ischemic stroke mortality and a 37.7% decrease in hemorrhagic stroke mortality. Despite the decline in age-standardized CVD mortality in 2013 compared to 1990, the absolute number of CVD deaths is still rising rapidly due to factors such as the aging of the Chinese population, which increased by 46% in 2013 compared to 1990. Among them, ischemic heart disease deaths increased by 90.9% and cerebrovascular disease deaths increased by 47.7%. 2. hypertension The 2012 National Survey on Nutrition and Chronic Diseases reported that the prevalence of hypertension among Chinese residents aged 18 years or older was 25.2%, 26.8% for urban residents and 23.5% for rural areas. According to the sixth national census in 2010, the number of people with hypertension was estimated to be 270 million. The Report on the Status of Nutrition and Chronic Diseases of the Chinese Population (2015) surveyed that the awareness rate, treatment rate and control rate of hypertension among people over 18 years of age increased significantly in 2012, at 46.5%, 41.1% and 13.8% respectively. 3. dyslipidemia The 2010 China Chronic Disease Surveillance Study reported that the serum total cholesterol (TC) and triglyceride (TG) levels of people aged ≥18 years in 31 provinces (municipalities and autonomous regions) in China were significantly higher than those in 2002. In the 2010 China Chronic Disease Surveillance Study, the prevalence of elevated TC (TC ≥ 6.22 mmol/L) was 3.4% for men and 3.2% for women, and the prevalence of elevated TG (TG ≥ 2.26 mmol/L) was 13.8% for men and 8.6% for women. In 2012, the prevalence of elevated TC (TC≥6.22mmol/L) was 4.7% for men and 5.1% for women, and the prevalence of elevated TG (TG≥2.26mmol/L) was 16.7% for men and 9.8% for women, both of which were significantly higher than in 2010, and both were higher in urban than in rural areas. The prevalence, awareness, treatment and control rates of hypercholesterolemia in people aged 20 years or older were investigated in the Chinese Diabetes and Metabolic Abnormalities Study from 2007 to 2008, and the prevalence of TC ≥6.22 mmol/L was 8.7% and 9.3% in men and women, respectively; the awareness rates were 27.6% and 20.7%, respectively; the treatment rates were 21.4% and 14.0%, respectively; and the control rates were 18.3% and 11.5%, respectively. The control rate was 18.3% and 11.2% respectively, and the treatment control rate was 88.1% and 78.4% respectively. The 2011 China Dyslipidemia Patient Management and Cholesterol Attainment Survey showed that 39% of dyslipidemic patients received lipid-lowering therapy, with the majority using statins. The attainment rate for low-density lipoprotein cholesterol (LDL-C) was 25.8%, and 19.9% and 21.1% for those with high and very high cardiovascular risk strata, respectively. 88.9% of inpatients were treated with statins in the 2012 Dyslipidemia International Study – China (DYSIS-China). In patients receiving lipid-modifying drugs, 38.5% did not achieve LDL-C target values, and the non-attainment rate was higher in the higher cardiovascular disease risk stratification group. 4. diabetes The 2010 China Chronic Disease Survey data published in September 2013 showed a prevalence of 9.7% of Chinese adults with diabetes based on previous diagnosis of diabetes and fasting glucose/2-hour postprandial glucose testing. If glycated hemoglobin (HbA1c) levels were also referenced, the prevalence of diabetes was 11.6%. For both men and women, the prevalence of diabetes is higher in urban than in rural areas. 5. cerebrovascular disease The results of the National Health Service Survey showed that the overall prevalence of cerebrovascular disease in China was on the rise between 1993 and 2013. the fifth survey in 2013 showed that the prevalence of cerebrovascular disease in urban areas (12.1‰) decreased, while in rural areas (12.3‰) it still showed a significant increase. Figure 3 Trends in the prevalence of cerebrovascular disease in urban and rural China from 1993 to 2013 According to the China Health and Family Planning Statistical Yearbook, the mortality rate of cerebrovascular disease among urban residents in 2015 was 128.23/100,000, including 52.09/100,000 for cerebral hemorrhage and 41.82/100,000 for cerebral infarction. The mortality rate of cerebrovascular disease among rural residents was 153.63/100,000, including 72.26/100,000 for cerebral hemorrhage and 46.99/100,000 for cerebral infarction. Accordingly, based on the data of the sixth census, the number of urban residents who died from cerebrovascular disease in 2015 was 853,600 and 1,034,900 in rural areas. Overall, the mortality rate of cerebrovascular disease was higher in rural areas than in urban areas. Figure 4 Trends in mortality rates of cerebrovascular diseases among Chinese residents from 2003 to 2015 6. Coronary heart disease According to the 2016 China Health and Family Planning Statistical Yearbook, the mortality rate of coronary heart disease among urban residents in China was 110.67/100,000 in 2015, and 110.91/100,000 among rural residents, which was slightly higher compared with the previous year (110.5/100,000, 105.37/100,000 The mortality rate of coronary heart disease in rural areas was 110.91/100,000, which was slightly higher compared with the previous year (110.5/100,000, 105.37/100,000). Overall, the mortality rate of coronary heart disease was slightly higher in rural areas than in urban areas, and higher in men than in women. Figure 5 Trends of coronary heart disease mortality rates in urban and rural areas from 2002 to 2015 The mortality rate of acute myocardial infarction in general showed an increasing trend from 2002 to 2015, and from 2005 onward, the mortality rate of acute myocardial infarction showed a rapid increasing trend, and the mortality rate of acute myocardial infarction in rural areas not only exceeded that in urban areas several times in 2007, 2009, and 2011, but also in 2012 The mortality rate of acute myocardial infarction in rural areas not only exceeded that in urban areas several times in 2007, 2009 and 2011, but also began to increase significantly in 2012, and exceeded the urban average significantly. Figure 6 Trends of acute myocardial infarction mortality in urban and rural areas from 2002 to 2015 According to the fifth health service survey in China in 2013, the prevalence of ischemic heart disease was 12.3‰ in urban population aged 15 years and above, 8.1‰ in rural survey areas, and 10.2‰ in urban and rural areas combined. the prevalence of ischemic heart disease in people aged 60 years and above was 27.8‰. Based on this data, the prevalence of ischemic heart disease in the population aged 15 years or older in mainland China was about 11,396,104 in 2013, according to the data of the sixth population census in 2010. According to the data declared by the PCI network of the National Health and Family Planning Commission, the growth rate of the number of cases of percutaneous coronary intervention in China tended to be stable from 2010 to 2015. the total number of cases of coronary intervention in mainland China was 567,583 in 2015. The average number of patients treated with percutaneous coronary intervention per million population in China was 426.82. The average number of stents implanted basically remained at about 1.5. Interventional indications and device use tend to be reasonable. The mortality rate of interventions was stabilized at a low level, and the number of emergency percutaneous coronary interventions for patients with ST-segment elevation myocardial infarction increased. 7. arrhythmias According to the online registration information of the National Health and Family Planning Commission in 2015, about 65,697 pacemakers were implanted in 2015, an increase of 9.98% compared with 2014; the indications for pacemakers did not change significantly compared with 2014: pathological sinus node syndrome accounted for 51.1%, atrioventricular block accounted for 39.8%; dual-chamber pacemakers accounted for nearly 69%. According to the information of the online registration system of the National Health Planning Commission, the implantation of cardioverter-defibrillators (ICDs) has been on a continuous growth trend in recent years, with an annual growth rate of more than 10%, with growth rates of 22.9%, 10.3% and 18.3% in 2013, 2014 and 2015, respectively. 2759 ICDs were implanted in 2015, and the proportion of single-chamber and dual-chamber ICDs was similar to that in 2014. Similar to 2014, single-chamber ICDs accounted for 67.1% and dual-chamber ICDs accounted for 32.9%; ICDs for secondary prevention accounted for 58.0% and primary prevention accounted for 42.0%. Cardiac resynchronization therapy (CRT) was performed in 2986 cases in 2015, an increase of 8.4% compared with 2014. 57% of CRT-D and 45% of CRT-P were performed. A multicenter study led by Fu Wai Hospital, Chinese Academy of Medical Sciences, summarized 73 CRT patients with home monitoring implanted in 97 hospitals nationwide, and found abnormal alarm events visible in 92.7% of patients at 6-month follow-up, including 85% of disease-related events and 15% of system-related events, earlier than the corresponding events detected at 3- and 6-month outpatient follow-up. Catheter ablation procedures have continued to grow rapidly since 2010, with annual growth rates of 13.5% to 17.5%, and 111,000 radiofrequency ablation procedures in 2015. A survey in 2004 in 10 different regions of China (4 urban and 6 rural areas) showed that the prevalence of atrial fibrillation was 0.42% in people aged 35-59 years and 1.83% in people aged 60 years or older, with an age-sex corrected prevalence of 0.77% (0.78% in men and 0.76% in women). 8. Heart failure A survey of 15518 people in 20 urban and rural areas in 10 provinces and cities in China showed that the prevalence of chronic heart failure among people aged 35-74 years in China in 2000 was 0.9%; 0.7% for men and 1.0% for women; higher in the north (1.4%) than in the south (0.5%), and higher in urban areas (1.1%) than in rural areas (0.8%). The analysis of 8516 heart failure patients in 88 hospitals from 2012 to 2014 in the China Heart Failure Registry (China-HF) study led by Fu Wai Hospital showed that the morbidity and mortality rate of hospitalized heart failure patients was 5.3%. According to the China Heart Failure Registry Study, the current average age of heart failure patients is (66 ± 15) years, with an increasing trend, 54.5% are male, and 84.7% have New York Heart Association cardiac function class III to IV. The composition of major comorbidities in heart failure has changed significantly, with the proportion of valvular disease decreasing year by year and hypertension (54.6%), coronary artery disease (49.4%) and chronic kidney disease (29.7%) becoming the major comorbidities. Infection remained the leading cause of heart failure episodes, accounting for 45.9%, followed by exertion or stress (26.0%) and myocardial ischemia (23.1%). There was no significant change in the use of diuretics in hospitalized heart failure patients. The use of digoxin (26.1%) showed a decreasing trend influenced by international clinical studies, and the use of ARB (24.6%), aldosterone receptor antagonists (55.4%) and β-blockers (50.6%) increased significantly. 9. chronic obstructive pulmonary disease (COPD) The 2007 epidemiological survey showed that the prevalence of COPD was 8.2% in people over 40 years old, 8.8% in rural areas and 7.8% in urban areas. It is estimated that there are 43 million cases of COPD in the country. 10. pulmonary embolism The National Pulmonary Embolism Prevention and Control Project conducted a study on the registration of patients with pulmonary embolism in more than 60 tertiary hospitals nationwide from 1997 to 2008, and the incidence of pulmonary embolism was 0.1% among 16,972,182 hospitalized patients. 11. chronic kidney disease The results of the Chinese chronic kidney disease survey conducted from September 2009 to September 2010 among 47,204 adults aged 18 years or older in 13 provinces and cities showed that the prevalence of chronic kidney disease was 10.8%, of which the prevalence diagnosed by eGFR <60 ml/(min?1.73m2) was 1.7%, while the prevalence diagnosed by urinary albumin to creatinine ratio >30 mg/ g was 9.4%. It is estimated that there are nearly 120 million patients with chronic kidney disease in China. 12. cardiovascular surgery Coronary artery bypass grafting is one of the most important procedures in cardiovascular surgery in China, with an annual volume of about 40,000 procedures. Due to the aging of the population and the gradual development of various risk factors, the annual volume of coronary artery bypass grafting in China is increasing at a rate of 10% year by year, which is significantly faster than that of congenital heart disease surgery, and may become the most important procedure in Chinese cardiac surgery in the future. About 60% of simple CABG in China is performed with non-extracorporeal circulation support, compared to about 20% in the West. The overall mortality rate for simple coronary artery bypass grafting in large Chinese cardiac centers is 1.9% and the rate of major complications is 6.4%, There is no longer a statistical difference between the two countries in terms of mortality and complication rates of coronary artery bypass grafting. The etiology of heart valve disease in China is mainly rheumatic heart disease, with younger patients and fewer comorbidities. However, as the population ages, the average age of Chinese heart valve surgery patients is increasing, and the corresponding risk factors will increase.