China the largest developing nation in the world has undergone dramatic social and economic changes over the last few decades with a major shift in the pattern of diseases affecting the country. However, China’s major health threat is dealing with chronic diseases which now account for more than three quarters of all deaths.
Cardiovascular Diseases (CVD) currently the leading cause of death in China is responsible for about 2.6 million deaths annually. By 2020, this figure is projected to increase to four million deaths per year.
The China International Center for Chronic Disease Prevention one of eleven Centers of Excellence www.georgeinstitute.org/units/china-international-centre-for-chronic-disease-prevention was established by NIH’s National Heart, Lung and Blood Institute (NHLBI) www.nhlbi.nih.gov, the UnitedHealth Chronic Disease Initiative www.unitedhealthgroup.com, and the UnitedHealth Group www.unitedhealthgroup.com.
The researchers in the centers are from leading academic institutions from the U.S, Australia, and the UK as well as five regional institutes within China.
The Centers of Excellence are working in partnership with the Peking University Health Sciences Center http://English.bjmu.edu.cn to do chronic disease research, prevention, and treatment. This is being done by targeting healthcare initiatives, capacity building, and policy engagement.
In another international endeavor, an international collaboration was established between Chinese and Indian researchers to develop new more cost-effective ways to improve primary care and clinical outcomes in regions with limited resources.
Despite the differences in the healthcare systems, socioeconomic, environment differences, and culture, China and India both face similar challenges in CVD prevention and control that is greatly needed with the rising burden of CVD, large urban-rural health disparities, and limited resources.
One joint project known as the SimCard study was a one year cluster-randomized controlled trial carried out in 47 villages in Tibet, China, and Haryana, India where access to basic CVD management and appropriate medications are limited. The George Institute for Global Health at Peking University Health Science Center (PUHSC) in collaboration with Tibet University in China and the Public Health Foundation of India www.phfi.org conducted the study.
The study enrolled 2,086 individuals with high CVD risks, over 40 years old with a history of CVD, plus a measured systolic blood pressure over 160mmHg. The study participants were given two medications that included blood pressure lowering agents, aspirin, and two lifestyle modifications that included smoking cessation and salt reduction.
Community Health Workers (CHW) were trained to manage the individuals in the study by using an Android smartphone app consisting of a guideline-based but simplified CVD management program. It was found that the electronic decision support system assisted the CHWs to provide standard and prompt care for the first time in these poorer settings.
In China, study participants showed a significant decrease in systolic blood pressure and an increase in the number of participants taking aspirin. It was noted by Professor Lijing Yan, Principal Investigator for the study, “Relying just on the overburdened and relatively small number of specialists needed to treat the high-risk people in these areas is not feasible or sustainable. CHWs are the key components for successfully carrying out these population-based strategies for CVD prevention and control.”