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Report on Cardiovascular Diseases in China 2018 中国心血管病报告 2018

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REPORT ON CARDIOVASCULAR DISEASES IN CHINA 2018 中国心血管病报告 2018 National Center for Cardiovascular Diseases, China 国家心血管病中心 Encyclopedia of China Publishing House 图书在版编目 (CIP)数据 中国心血管病报告. 2018：英文 / 国家心血管病中 心编著. -- 北京 ：中国大百科全书出版社，2019.11 ISBN 978-7-5202-0632-7 Ⅰ.①中… Ⅱ.①国… Ⅲ. ①心脏血管疾病－研究报 告－中国－2018－英文 Ⅳ .①R54 中国版本图书馆CIP数据核字 (2019)第256560号 责任编辑：杨 振 出版发行 (北京阜成门北大街17号 邮政编码：100037 电话：010-88390752) http://www.ecph.com.cn 北京骏驰印刷有限公司印刷 (北京市海淀区西北旺屯佃工业园区289号) 新华书店经销 开本：889×1194毫米 1/16 印张：15 字数:300千字 2019年12月第一次印刷 印数：1－3000册 ISBN 978-7-5202-0632-7 定价:128.00元 本书如有印装质量问题，可与本出版社联系调换。 ISBN 978-7-5202-0632-7 Copyright by Encyclopedia of China Publishing House,Beijing,China,2019.11 Published by Encyclopedia of China Publishing House 17 Fuchengmen Beidajie,Beijing,China 100037 http://www.ecph,com.cn Distributed by Xinhua Bookstore First Edition 2019.12 Printed in the People´s Republic of China EDITORIAL COMMITTEE for Report on Cardiovascular Diseases in China (2018) Chief Editor Hu Shengshou Associate Editors Gao Runlin; Wang Zheng; Liu Lisheng; Zhu Manlu; Wang Wen;Wang Yongjun; Wu Zhaosu; Li Huijun; Gu Dongfeng;Yang Yuejin; Zheng Zhe; Chen Weiwei Academic Secretaries Ma Liyuan; Wu Yazhe Writing Group Members Chen Weiwei; Du Wanliang; Fan Xiaohan; Li Guangwei; Li Jing; Li lin; Li Xiaoying; Liu Jing; Liu Kejun; Luo Xinjin; Ma Liyuan; Mi Jie; Wang Jinwen; Wang Wei; Wang Yu; Wang Zengwu; Wu Yazhe; Xiong Changming; Xu Zhangrong; Yang Jingang; Yang Xiaohui; Zeng Zhechun; Zhang Jian; Zhang Shu; Zhao Liancheng; Zhu Jun; Zuo Huijuan Editorial Board Members Chang Jile; Chen Weiwei; Chen Yude; Du Wanliang; Gao Runlin; Gu Dongfeng; He Jianguo; Hu Shengshou; Kong Lingzhi; Li Guangwei; Li Huijun; Li Wei; Li Xiaoying; Liu Jing; Liu Kejun; Liu Lisheng; Luo Xinjin; Mi Jie; Rao Keqin; Tang Xinhua; Wang Wei; Wang Wenzhi; Wang Yilong; Wang Yongjun; Wang Yu; Wang Zengwu; Wang Zheng; Wu Liangyou; Wu Xigui; Wu Zhaosu; Xu Zhangrong; Yang Gonghuan; Yang Xiaohui; Yang Yuejin; Yao Chonghua; Zeng Zhechun; Zeng Zhengpei; Zhang Jian; Zhang Shu; Zhao Dong; Zhao Liancheng; Zhao Wenhua; Zheng Zhe; Zhu Jun; Zhu Manlu; Zuo Huijuan Academic Committee Members Cao Kejiang; Cao Xuetao; Chen Haozhu; Chen Hong; Chen Jiyan; Chen Keji; Chen Lianglong; Chen Lin; Chen Weiwei; Chen Xiangmei; Chen Yundai; Chen Zaijia; Cheng Xiansheng; Dong Yugang; Du Jie; Fang Quan; Gao Changqing; Gao Chuanyu; Gao Wei; Gesang Luobu; Ge Junbo; Gu Dongfeng; Guo Tao; Han Yaling; Hu Dayi; Hu Shengshou; Huang Congxin; Huang Dejia; Huang Lan; Hui Rutai; Huo Yong; Jia Shaobin; Jiang Shiliang; Kong Xiangqing; Lei Han; Li Fen; Li Guangwei; Li Guangping; Li Huijun; Li Jianjun; Li Lihuan; Li Liming; Li Ling; Li Wei; Li Xiaoying; Li Yong; Liao Yuhua; Lin Shuguang; Liu Bin; Liu Depei; Liu Jin; Liu Lisheng; Liu Weijun; Liu Xiaocheng; Liu Yuqing; Long Cun; Ma Changsheng; Ma Yitong; Pan Changyu; Shen Weifeng; Shi Dazhuo; Sun Ningling; Sun Yingxian; Tang Baopeng; Tang Chaoshu; Wan Zheng; Wang Daowen; Wang Chen; Wang Chunsheng; Wang Fangzheng; Wang Jiguang; Wang Jian' an; Wang Jingfeng; Wang Shiqiang; Wang Wei; Wang Xian; Wang Yongjun; Wang Zengwu; Wang Zheng; Wu Liqun; Wu Ming; Wu Yiling; Wu Zhaosu; Wu Zonggui; Wu Weifeng; Xiao Chuanshi; Xiao Ruiping; Xu Bo; Xu Zhangrong; Yan Ji; Yan Xiaowei; Yang Baofeng; Yang Jiefu; Yang Tianhe; Yang Xinchun; Yang Yuejin; Yao Chonghua; Yi Dinghua; Yu Bo; Yuan Zuyi; Zeng Zhengpei; Zhang Shuyang; Zhang Shu; Zhang Yun; Zhang Zheng; Zhao Dong; Zhao Shuiping; Zhao Xingsheng; Zheng Yang; Zheng Zhe; Zhou Shenghua; Zhu Jianhua; Zhu Xiaodong; Zhu Junren; Zhu Zhiming; Zhuang Jian Translators China Oxford Center for International Health Research, Fuwai Hospital, China: Ge Yilan; Huo Xiqian; Lu Jiapeng; Su Meng; Wu Chaoqun; Wang Xiuling; Yi Jiayi; Yu Yuan; Zhang Danwei; Zhang Lihua; Zhang Qiuli; Zhang Xingzi Yale University, US Luo Jiesi University of Missouri, US Shen Yuanyuan Adivo Associates LLC Zhu Xianglong Oxford University Usama Ali Text Proofreaders National Center for Cardiovascular Diseases, Fuwai Hospital, China: Ma Liyuan Department of Geriatric Cardiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University Zhao Yong Preface Rapid socioeconomic progress in China has greatly impacted the lifestyle of citizens. The tendency to develop cardiovascular diseases (CVD) has increased in China as a consequence of lifestyle changes, urbanization, and the accelerated aging of the population. The incidence of CVD has been continuously increasing and will continue an upward trend in the next decade. CVD is the leading cause of death in both urban and rural Chinese populations. Currently, 45.50% of deaths in rural areas and 43.16% in urban areas are attributable to CVD. The growing burden of CVD has become a major public health issue. Effective strategies for the prevention and treatment of CVD should be enforced urgently under the supervision of the government. On 14th February 2017, General Offi ce of the State Council issued The Medium- and Long-term Plan for Chronic Disease Prevention and Control in China (2017-2025), a guideline for the prevention and control of chronic diseases, especially CVD in China, which should be appropriately followed and implemented as the recommendations. Since 2005, the National Center for Cardiovascular Diseases has been recruiting experts nationwide to compile the Report on Cardiovascular Diseases in China annually (herein after referred to as the annual report). To date, 13 annual reports have been published. In the year of the publication of the fi rst annual report, it was selected among the top ten academic news for its innovation and importance. In 2015, the National Health Commission listed the annual report as one of the fi ve most important regularly- released health information in the fi eld of diseases prevention and control in China. The annual report was published to dynamically track the prevalence of CVD and comprehensively evaluate the progress of research on CVD prevention in the country. It covers various aspects of the research and development of prevention for CVD throughout the nation, primarily focusing on monitoring cardiovascular (CV) epidemic trends to guide the management of CVD. The report seeks to be comprehensive, timely, accurate and complete, to refl ect its representativeness and authority, and to provide technical guidance for the government, medical research institutions and communities to carry out more effective research on prevention and control of CVD. In addition to maintaining the continuity of the core content in the previous annual reports, the Report on Cardiovascular Diseases in China 2018 has added three key points to deal with the current severe situation of CVD in China: (1) Prediction for the trend of CVD and individual risks in Chinese population. A comprehensive analysis of predictive models on CVD risks was performed in individuals or populations at different control levels of risk factors, emphasizing a lifetime risk assessment for young- and middle- aged people with low- or intermediate-level of risk of CVD, to facilitate the early prevention and control of CVD; (2) Medical care quality assessment on CVD. Based on relevant literatures published in recent years, objective analysis was conducted on the medical care quality of CVD in China. It revealed that both progress and weakness exist. In 2015, the medical care quality and accessibility index in China 1 Report on Cardiovascular Diseases in China 2018 ranked the 48th in the world, and the progress ranked third between 1990 to 2015. The medical care quality of CVD in China is improving steadily. The proportion of implementing standardized medications and other treatments recommended by the guidelines is increasing, but there is still much room for improvement. Moreover, the disparity of medical care capabilities in different hospitals at different levels is still signifi cant. (3) At the end of the annual report 2018, we added the appendix of Guidelines for CVD Released in China in the Past Five Years , listing the titles, institutions, and the published journal names for reference. It should be noted that the term “cardiovascular diseases” in this report refers to cardiovascular and cerebrovascular diseases, as well as their related diseases. The information in the annual report is an essential reference for the government to formulate relevant policies. It serves as an information platform for national prevention and control of CVD, and for international communication and cooperation. It is also a crucial element of enhancing China's international status and infl uence in the research fi eld of CVD management. The work of compiling the Report on Cardiovascular Diseases in China has received full support from the leaders of the National Health Commission, the National Center for Cardiovascular Diseases, the Fuwai Hospital, the annual report writing group members, the editorial board, and the academic committee, especially the experts from the writing group. We would like to express our deep appreciation to them. Although we strive for excellence in the process of writing, there might still be some missing information. We look forward to having valuable opinions from the readers to make the annual report better. 2 Abbreviations and Acronyms ABI：Ankle Brachial Index CI：Confi dence Interval ACC：American College of Cardiology CIMIC：Community Intervention of Metabolic ACEI：Angiotensin Converting Enzyme Inhibitor Syndrome in China ACR：(Urinary) Albumin/Creatinine Ratio CKB：China Kadoorie Biobank ACS：Acute Coronary Syndrome CKD：Chronic Kidney Disease
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    Pharmaceutical policy in China Challenges and opportunities for reform Elias Mossialos, Yanfeng Ge, Jia Hu and Liejun Wang Pharmaceutical policy in China: challenges and opportunities for reform Pharmaceutical policy in China: challenges and opportunities for reform Elias Mossialos, Yanfeng Ge, Jia Hu and Liejun Wang London School of Economics and Political Science and Development Research Center of the State Council of China Keywords DRUG AND NARCOTIC CONTROL PHARMACEUTICAL PREPARATIONS DRUG COSTS DRUG INDUSTRY HEALTH CARE REFORM HEALTH POLICY CHINA © World Health Organization 2016 (acting as the host organization for, and secretariat of, the European Observatory on Health Systems and Policies) All rights reserved. The European Observatory on Health Systems and Policies welcomes requests for permission to reproduce or translate its publications, in part or in full. Address requests about publications to: Publications, WHO Regional Office for Europe, UN City, Marmorvej 51, DK-2100 Copenhagen Ø, Denmark. Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the Regional Office web site (www.euro.who.int/pubrequest). The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the European Observatory on Health Systems and Policies concerning the legal status of any country, territory, city or area or of its authorities, or concern- ing the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the European Observatory on Health Systems and Policies in preference to others of a similar nature that are not mentioned.