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Abstract
China has undergone rapid socioeconomic development over the past 30 years, which has led to significant changes in lifestyle with a resulting increase in cardiovascular disease prevalence. A shift from traditional diets to high-fat diets and reduced physical activity, has contributed to a rapid increase in obesity and an increase in serum cholesterol levels in China, and these increases interact with the high prevalence of hypertension affecting the pattern of cardiovascular diseases. In China, lipid levels were higher in populations in the north or in urban areas compared with the south or rural areas, respectively. Chinese people in Singapore used to have higher total cholesterol and LDL-C levels than in China, but these have declined since the 1980s, whereas the cholesterol levels in Hong Kong and Taiwan have been in between those in China and Singapore. A higher ratio of unsaturated to saturated fats in the diet appears to have contributed to a lower incidence of coronary heart disease in Hong Kong and Taiwan compared with Singapore. Hypertriglyceridemia is a common feature of dyslipidemia in China, probably related to dietary and genetic factors, such as the frequency of APOA5 polymorphisms. The prevention and treatment of hypercholesterolemia, primarily by means of lifestyle modification and with additional pharmacotherapy when appropriate, should be an important objective to pursue in all Chinese populations to reduce the burden of coronary heart disease, which continues to increase in China.