Prevalence of chronic rheumatic heart disease in Chinese adults

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Abstract

Objectives

Rheumatic heart disease continues to be a common health problem in the developing countries. Though there is evidence indicating that rheumatic heart disease prevalence in China has decreased since the 1950s, no objective assessment of its present prevalence has been published. The study was designed to investigate the prevalence of chronic rheumatic heart disease in China.

Methods

We performed a community population based investigation from October 2001 to February 2002 in nine communities of nine provinces in China by using a multistage, random sample design. Rheumatic heart disease was diagnosed by echocardiographic imaging. Long-axis views of the mitral valve, color flow recordings were used to search for mitral and aortic regurgitations. M-mode and two-dimensional short- and long-axis views of the aortic root and left atrium were recorded for supporting the diagnosis.

Results

Of 9124 participants, 8652 completed the questionnaires and 8080 had comprehensive echocardiographic examinations. We found that 15 subjects had definite echocardiographic evidence of rheumatic heart disease. The rough prevalence of rheumatic heart disease was 186/100,000 adults (2 in 1000 adults).

Conclusions

Rheumatic heart disease affected approximately 2 million middle-aged to elderly Chinese, thus constituting a significant health burden. We investigated only urban and suburban communities, the result may underestimate the real prevalence of the disease in China.

Introduction

Rheumatic heart disease continues to be a common health problem in the developing countries, leading to morbidity and mortality among children and adults. In North American Indians, prevalence of rheumatic heart disease varied from 0.6/1000 among school-age children to < 0.05/1000 among those discharged from hospitals. In developing nations, rheumatic fever and rheumatic heart disease continue unabated, affecting an estimated 5 to 30 million people worldwide [1], [2], [3]. In China, though evidence indicates that rheumatic heart disease prevalence has decreased since the 1950s, its exact prevalence is unknown [4].

Knowledge of the prevalence of rheumatic heart disease is important for effective public health strategies for prevention and intervention. In the present study, we investigated the prevalence of rheumatic heart disease in China by using a data available from a large survey [5].

Section snippets

Samples

The study is a community-population based survey with a multistage, random sampling design and was approved by the Institutional Review Board of the participating hospitals and by the Beijing Municipal Commission of Science and Technology. The subjects were recruited from nine geographically diverse suburban and urban communities according to age, sex, and residential area on the local census tracts in China between October 2001 and February 2002. These tracts listed ages, names, addresses, and

Results

Participants (9124) were interviewed, and 8652 completed the questionnaires and underwent clinical evaluation, 8080 completed echocardiographic examinations. In this study, 20–29 year old women were the smallest age–gender group (7.8%), and 30–39 year old men were the largest age–gender group (11.6%). Workers were the largest occupational group (33%) and civil service employees the second largest (29.9%). Of 8080 subjects, 7882 were of Han nationality (96.9%), 14 Hui (0.2%), 10 Man (0.1%), and

Discussion

In this retrospective study, we found that the prevalence of chronic rheumatic heart disease was 186/100,000 adults and 10 times higher than the prevalence in industrialized countries such as Canada (0.22/1000) and Japan (0.14/1000) [9], [10]. It is thus a significant health burden in China. It has long been known that incidence of acute rheumatic fever and prevalence of rheumatic heart disease have declined since the 1950s, with improved living standards and public health, but the true

Acknowledgements

The authors wish to express their thanks to Beijing Municipal Commission of Science and Technology for their support.

References (12)

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