Epidemic of ischaemic heart disease and the educational disparities in China

Owing to the multiphase transformations in economy, society, natural environment, lifestyles and healthcare system that China has been experiencing over the past three decades, coupled with the rapid population ageing, China’s burden of non-communicable disease, particularly cardiovascular disease (CVD) and cancer, has been rising drastically.1 Both the incidence of and mortality from ischaemic heart disease (IHD) have been increasing dramatically since 1980s in China.1 In 2019, IHD was the second cause of deaths in the Chinese population, which counted for 17.6% of all deaths and 9.1% of disability-adjusted life years.2 Although there are ample evidence on the socioeconomic disparities in CVD in high-income countries, evidence is still limited in low- and middle-income countries such as China.3 The paper by Chen et al is the first comprehensive report on the educational disparities in IHD incidence, case fatality and mortality in China, using data from the large prospective cohort study of China Kadoorie Biobank. The study supplements findings of a robust inverse educational gradient in IHD case fatality …