Report on Cardiovascular Health and Diseases in China 2022:an Updated Summary

In the past 30 years,the accessibility and quality index of medical care have made remarkable progress in China,ranking the first among middle-income countries.Many cardiovascular technologies are at or near the world's leading level,and significant progress has been achieved in China solving the problem of“treatment difficulty”of cardiovascular diseases(CVD).However,due to the prevalence of unhealthy lifestyles among Chinese residents,a huge population with CVD risk factors,accelerated population aging,and other reasons,the incidence and mortality rate of CVD are still increasing,and the turning point of the decline in disease burden has not appeared yet in China.In terms of proportions of disease mortality among urban and rural residents,CVD still ranks the first.In 2020,CVD accounted for 48.00%and 45.86%of the causes of death in rural and urban areas,respectively;two out of every five deaths were due to CVD.It is estimated that the number of current CVD patients in China is around 330 million,including 13 million stroke,11.39 million coronary heart disease,8.9 million heart failure,5 million pulmonary heart disease,4.87 million atrial fibrillation,2.5 million rheumatic heart disease,2 million congenital heart disease,45.3 million peripheral artery disease,and 245 million hypertension cases.China has entered a new stage of transformation from high-speed development to high-quality development,and the prevention and control of CVD in China should also shift from previous emphasis on scale growth to strategies focusing more on strategic and key technological development in order to curb the trend of increasing incidence and mortality rates of CVD.

Factors Affecting Patient Satisfaction with Community Health Service under the Gatekeeper System:A Cross-sectional Study in Nanjing,China

The gatekeeper policy has been implemented for approximately ten years on a pilot population in China. It is necessary to assess the satisfaction of patients utilizing community health service（CHS） under the gatekeeper system. Our study showed that the cognition of gatekeeper policy was associated with four dimensions including doctor‐patient relationships, information and support, organization of care, and accessibility（P 〈 0.001）. One or more factors such as gender and self‐perceived health scores also affected their satisfaction. General practitioners must be prepared to focus on these aspects of information and support, organization of care, and accessibility as indicators of potential opportunities for improvement. Additionally, policymakers can improve patients＇ satisfaction with CHS by strengthening their awareness of the gatekeeper policy.

Patient and Health System Factors Associated with First Line Tuberculosis Treatment Adherence, 2009-2014

Background: The prevalence and incidence rate of tuberculosis remains high although the disease is known to be almost always curable provided the patient adheres to the treatment regimen. This study assessed the strength of association between known patient and health system factors associated with first line tuberculosis treatment adherence. Methods: A quantitative cross sectional study. Retrospective chart reviews were conducted among 570 persons who had primary tuberculosis and received first line treatment at a health facility within the Nkangala district, Mpumalanga province and who had a treatment outcome recorded between 1st January 2009 and 31st December 2014. Adherence to first line tuberculosis treatment was defined as taking ≥80% of tuberculosis prescribed drugs within a period of 6 to 8 months. Stata software (logistic regressions model) was used to analyze results and find the strength of association between known factors and treatment adherence. Results: Out of the 570 study participants, 473 were adherent and 96 were not adherent. There was a statistically significant association between age 18 years and above (OR: 1.02, P-value: 0.027), sex (lower in males OR: 0.44, P-value: 0.001) and support (OR: 3.04, P-value: 0.05) and HIV (OR: 1, P-value: 0.634) and first line TB treatment adherence. Conclusion and Recommendation: >80% adherence to first line tuberculosis outcome is possible. The support given to people with tuberculosis will further enhance adherence to first line tuberculosis treatment.

Report on Cardiovascular Health and Diseases in China 2021:An Updated Summary

In 2019,cardiovascular disease(CVD)accounted for 46.74%and 44.26%of all deaths in rural and urban areas,respectively.Two out of every five deaths were due to CVD.It is estimated that about 330 million patients suffer from CVD in China.The number of patients suffering from stroke,coronary heart disease,heart failure,pulmonary heart disease,atrial fibrillation,rheumatic heart disease,congenital heart disease,lower extremity artery disease and hypertension are 13.00 million,11.39 million,8.90 million,5.00 million,4.87 million,2.50 million,2.00 million,45.30 million,and 245.00 million,respectively.Given that China is challenged by the dual pressures of population aging and steady rise in the prevalence of metabolic risk factors,the burden caused by CVD will continue to increase,which has set new requirements for CVD prevention and treatment and the allocation of medical resources in China.It is important to reduce the prevalence through primary prevention,increase the allocation of medical resources for CVD emergency and critical care,and provide rehabilitation services and secondary prevention to reduce the risk of recurrence,re-hospitalization and disability in CVD survivors.The number of people suffering from hypertension,dyslipidemia and diabetes in China has reached hundreds of millions.Since blood pressure,blood lipids,and blood glucose levels rise mostly insidiously,vascular disease or even serious events such as myocardial infarction and stroke often already occured at the time of detection in this population.Hence,more strategies and tasks should be taken to prevent risk factors such as hypertension,dyslipidemia,diabetes,obesity,and smoking,and more efforts should be made in the assessment of cardiovascular health status and the prevention,treatment,and research of early pathological changes.

Risk factors associated with mortality of COVID-19 in 3125 counties of the United States

Background:The number of cumulative confirmed cases of COVID-19 in the United States has risen sharply since March 2020.A county health ranking and roadmaps program has been established to identify factors associated with disparity in mobility and mortality of COVID-19 in all counties in the United States.The risk factors associated with county-level mortality of COVID-19 with various levels of prevaIence are not well understood.Methods:Using the data obtained from the County Health Rankings and Roadmaps program,this study applied a negative binomial design to the courtty-level mortality counts of COVID-19 as of August 27,2020 in the United States.In this design,the infected counties were categorized into three levels of infections using clustering analysis based on time-var ying cumulative con firmed cases from March 1 to August 27,2020.COVID-19 patients were not analyzed in dividually but were aggregated at the county-level,where the coun ty-level deaths of COVID-19 con firmed by the local health agencies.Clustering analysis and Kruskal-Wallis tests were used in our statistical analysis.