Wang Lu, Wang Yuzhu, Ji Zixiang, Zhu Rongyu, Wu Hengjing, Li Jue, Zheng Liang, Zhang Lijuan
Clinical Center for Intelligent Rehabilitation Research, Shanghai YangZhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), Tongji University School of Medicine, Tongji University, Shanghai, China.
School of Public Health and General Practice Medicine, Tongji University School of Medicine, Tongji University, Shanghai, China.
Ann Med. 2025 Dec;57(1):2455534. doi: 10.1080/07853890.2025.2455534. Epub 2025 Jan 22.
Cardiovascular disease (CVD) is the top cause of death in China. We aimed to identify trends in cause-specific CVD mortality in a rapidly developing country, thereby providing evidence for CVD prophylaxis.
Using raw data from the Chinese National Mortality Surveillance (CNMS) system, we assessed the mortalities of all CVD and cause-specific CVD during 2009-2019. Temporal trends of crude mortality rates (CMRs) and age-standardized mortality (ASMRs) of CVD were evaluated using joinpoint regression models. Age-sex-specific CVD mortality rates were predicted by using age-period-cohort Poisson regression model.
A total of 10,608,402 CVD death occurred during 2009-2019, accounting for 49.8% of all-cause of death in China. The three major CVD types [cerebrovascular disease, ischemic heart disease (IHD) and hypertensive disease (HD)] accounted for 94.6% of total CVD deaths. The CMR of all CVD increased [the annual average percentage change (AAPC) = 3.4%, 95% confidence interval (CI) 2.6% to 4.1%] while the ASMR decreased (AAPC = -2.0%, 95% CI -3.5% to -0.6%). Cerebrovascular disease is predicted to be the leading cause of CVD death in men and IHD will be the top cause of CVD death in women over the period 2025-2029.
Although the ASMR of total CVD decreased, CVD remained the leading cause of death in China. Cerebrovascular disease, IHD and HD were the major three leading causes of CVD-related death. Inflammatory heart disease-associated death increased in the young population. Attention should be paid to premature deaths associated with cerebrovascular disease and rheumatic heart disease among rural residents.
心血管疾病（CVD）是中国的首要死因。我们旨在确定一个快速发展国家中特定病因的心血管疾病死亡率趋势，从而为心血管疾病预防提供证据。
利用中国国家死亡率监测（CNMS）系统的原始数据，我们评估了2009年至2019年期间所有心血管疾病及特定病因心血管疾病的死亡率。使用Joinpoint回归模型评估心血管疾病粗死亡率（CMRs）和年龄标准化死亡率（ASMRs）的时间趋势。通过年龄-时期-队列泊松回归模型预测特定年龄和性别的心血管疾病死亡率。
2009年至2019年期间共发生10,608,402例心血管疾病死亡，占中国全死因的49.8%。三种主要心血管疾病类型[脑血管疾病、缺血性心脏病（IHD）和高血压疾病（HD）]占心血管疾病总死亡人数的94.6%。所有心血管疾病的粗死亡率上升[年平均百分比变化（AAPC）=3.4%，95%置信区间（CI）2.6%至4.1%]，而年龄标准化死亡率下降（AAPC=-2.0%，95%CI -3.5%至-0.6%）。预计在2025年至2029年期间，脑血管疾病将成为男性心血管疾病死亡的主要原因，而缺血性心脏病将成为女性心血管疾病死亡的首要原因。
尽管心血管疾病的年龄标准化死亡率下降，但心血管疾病仍是中国的主要死因。脑血管疾病、缺血性心脏病和高血压疾病是心血管疾病相关死亡的三大主要原因。年轻人群中与炎症性心脏病相关的死亡增加。应关注农村居民中与脑血管疾病和风湿性心脏病相关的过早死亡。
