Heart disease: Asia catches up

February 21, 2000

Judith Zwolak

Stroke, heart attack, high blood pressure, these are Western imports that Asia could well do without. Unfortunately, business is booming in the export of cardiovascular disease to Asia and the culprit appears to be other Western "products": a high-fat diet, sedentary lifestyle and cigarette smoking.

To study the prevalence of risk factors for cardiovascular disease in Asia, Tulane researchers will evaluate 15,000 adults in China and 5,000 adults in Thailand over the next two years. The research, supported by a $1.4 million grant from Pfizer Pharmaceuticals, aims to document the causes behind the rising incidence of heart disease, says Jiang He, assistant professor of epidemiology at the School of Public Health and Tropical Medicine and principal investigator of the study.

Paul Whelton, senior vice president for the health sciences and former public health school dean, is also a principal investigator. "Unlike the United States, where the mortality of stroke and coronary heart disease has declined dramatically during the past 20 to 30 years, in Southeast Asia, mortality of coronary heart disease has increased because people have changed their lifestyles," He says.

Tulane will collaborate with researchers from the University of Sydney, Australia, the Chinese Academy of Medical Sciences and Mahidol University in Thailand to gather data and evaluate findings. In the study, volunteers aged 40 and over will provide lifestyle information on cigarette smoking, exposure to second-hand smoke, alcohol consumption and physical activity. Researchers will also measure the volunteers' blood pressure, glucose and blood-lipid levels and weight.

"Tulane's responsibilities are to oversee the whole study and design the study," He says. "We will develop the questionnaire and the methods of collecting the data and train local physicians in China and Thailand to collect the data."

He will travel to China in March to plan the study's protocol and begin a pilot study to test the data collection instruments and fine-tune the lifestyle questionnaire. The full study will begin in May and will cover both rural and urban populations in all areas of China and Thailand. He says the study will add crucial information about how lifestyle habits affect heart and pulmonary diseases such as heart attacks and stroke.

Heredity alone can't explain why the average serum cholesterol level of Chinese adults rose from an average of 150 to 190 since the 1980s, He says. "This study will provide nice information about cardiovascular disease risk factors in China and Thailand," He says. "We hope to follow up on this population in five to 10 years and look at cardiovascular risk factors again."

The study adds to He's numerous heart-disease research in his native country. One study looks at nutritional intervention to prevent hypertension and another is a 10-year prospective study of 350,000 Chinese adults. A previous study He began while at Johns Hopkins School of Hygiene and Public Health linked dietary changes to higher rates of cardiovascular disease in a population of rural Chinese farmers who moved to urban areas.

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