Cardiology in People's Republic of China in 1977.

((7 Ficuax 1. Chinese-made treadmill for stress electrocardiographic studies. n 1973, a year after reestablishment of Sino-Amer-ican communication and following two personal visits, I presented a report entitled " Cardiology in People's Republic of China. " It is the purpose of this communication to bring up to date, four years and two more visits later, the more recent developments in the field of cardiovascular disease in China. Coronary arterial disease continues to be the second most common cardiovascular disease in China, as it was in 1973.' In combination with strokes, coronary arterial disease is the number one killer in China. In detection of cases, as well as in clinical diagnosis, China (which until 1973 used only Master's two-step test) now employs treadmills (Fig 1). The electrocardiographic stress test, which was not widely used in 1972, is now used in large-scale surveys in factories and communes in many major cities in China. Although surgery for coronary bypass has been performed in China since May 1975 (on a 50-year-old man with intractable angina whom I saw in consultation during my visit to the Kwangtung Provincial People's Hospital, Canton, in 1975) and later also in Peking, the Chinese physicians and surgeons are far more cautious than their American colleagues , and rightfully so, in accepting the surgical treatment of ischemic heart disease. With the combined use of such modem Western drugs as practolol and propranolol (manufactured in China but called " Inderal, " as many other Chinese-made Western drugs [such as " Miltown " and " Librium'l are frequently called by their brand names, rather than by their generic names) and traditional Chinese herbal medicines (including Ligusticum wallichii and ginseng) ,, most of the Chinese patients with angina would respond to medical therapy; however , intractable angina is a definite indication to perform surgery for aortocoronary bypass. To me, this careful approach on the part of the Chinese seems not only medically wise but economically sound, so as not to direct resources away from other