Perspectives on the development of cardiovascular surgery in China from the perspective of declining birth rate, aging population, and changing dietary structure
10.3760/cma.j.cn431274-20250709-00910
- VernacularTitle:从人口出生率下降、老龄化及饮食结构变化看中国心血管外科发展
- Author:
Wangping CHEN
1
;
Chengming FAN
1
;
Jinfu YANG
1
Author Information
1. 中南大学湘雅二医院心血管外科，长沙 410011
- Publication Type:Journal Article
- Keywords:
Cardiovascular surgery;
Disease spectrum;
Birth rate;
Aging population;
Dietary structure
- From:
Journal of Chinese Physician
2025;27(8):1121-1124
- CountryChina
- Language:Chinese
-
Abstract:
Cardiovascular surgery in China has undergone leapfrog development, from learning and introducing technologies, to independent innovation, and now leading the world in some fields. Currently, the continuous decline in the birth rate, accelerated aging process, and westernization of dietary structure have profoundly reshaped the epidemiological spectrum of cardiovascular diseases, posing a " triple impact" on the development of cardiovascular surgery. This article summarizes their impacts: (1) Congenital heart disease (CHD): The reduction in newborns has led to a decrease in the absolute number of surgeries, but the popularization of prenatal diagnosis and improved treatment capabilities have relatively increased the proportion of complex CHD cases. The population of adult CHD patients is large and their management has become more complex. (2) Acquired heart disease: Aging has driven a significant increase in the volume of surgeries for coronary artery bypass grafting (CABG), valvular heart disease (especially degenerative lesions), atrial fibrillation surgery, and heart failure (heart transplantation and left ventricular assist devices). Patients are characterized by advanced age, critical conditions, and multiple comorbidities. (3) Great vessel diseases: Hypertension, atherosclerosis, and aging have caused a sharp increase in the incidence and surgical volume of aortic aneurysms/aortic dissections, with endovascular treatment becoming an important approach. To address these challenges, future development directions focus on: Technological innovation (minimally invasive surgery, interventional/hybrid techniques, mechanical circulatory support, precision medicine, and regenerative medicine); Transformation of diagnosis and treatment models (establishing full-life-cycle management of CHD, strengthening multidisciplinary heart team decision-making, and promoting enhanced recovery after surgery); Resource optimization (regional collaborative hierarchical diagnosis and treatment, capacity building at the grassroots level, and adaptation to medical insurance payment reforms); Talent training and scientific research innovation (cultivating interdisciplinary talents, strengthening clinical research, and innovating domestic medical devices). Cardiovascular surgery in China needs to actively adapt to changes in population structure and safeguard national heart health through continuous innovation and system optimization.
