Burden of cardiovascular disease in Asia: big challenges and ample opportunities for action and making a difference.

Cardiovascular disease (CVD) is the leading cause of death in the world, accounting for 30% of deaths globally. The major cardiovascular diseases include coronary or ischemic heart disease, cerebrovascular disease or stroke, hypertension, heart failure, and rheumatic heart disease. Although the CVD mortality rate has declined in the US and the rest of the developed world, the rate has increased in the developing world, including most Asian countries. The estimated number of deaths due to CVD worldwide was 17.5 million in 2005 and will increase to 20 million in 2015. Further, Asian countries have disproportionately high morbidity and mortality from stroke compared with Western countries. These unique patterns of CVD deserve more attention, because half of the world’s population lives in Asia. The December themed issue of Circulation highlighted reviews and original studies on risk factors, prevalence, awareness, treatment, control, mortality, and secular trends of CVD in Asia with a specific focus on China, India, Japan, and Korea. As pointed out in the editorial comment in that issue of Circulation, the relationship between traditional risk factors and CVD is different in Asia than in Western societies, and there are some unique features about risk factors and metabolic abnormalities for CVD in Asia (1 ). For example, hypertension plays a more important role in the development of heart disease and stroke in Asia than in Western countries. The prevalence of obesity and overweight in Asia has been increasing as a consequence of economic development in the past two to three decades. The rate of increase for diabetes has been even more substantial. Mean cholesterol levels are lower for adults in most Asian countries than in Western countries, but an increasing trend has been observed. Genetic predisposition and the interaction between genetic and environmental factors also contribute to the difference in CVD between Asians and people living on other continents.