Prevalence of chronic rheumatic heart disease in Chinese adults

Objectives Rheumatic heart disease continues to be a common health problem in the developing countries. Though there is evidence indicating that rheumatic heart disease prevalence in China has decreased since the 1950s, no objective assessment of its present prevalence has been published. The study was designed to investigate the prevalence of chronic rheumatic heart disease in China. Methods We performed a community population based investigation from October 2001 to February 2002 in nine communities of nine provinces in China by using a multistage, random sample design. Rheumatic heart disease was diagnosed by echocardiographic imaging. Long-axis views of the mitral valve, color flow recordings were used to search for mitral and aortic regurgitations. M-mode and two-dimensional short- and long-axis views of the aortic root and left atrium were recorded for supporting the diagnosis. Results Of 9124 participants, 8652 completed the questionnaires and 8080 had comprehensive echocardiographic examinations. We found that 15 subjects had definite echocardiographic evidence of rheumatic heart disease. The rough prevalence of rheumatic heart disease was 186/100,000 adults (2 in 1000 adults). Conclusions Rheumatic heart disease affected approximately 2 million middle-aged to elderly Chinese, thus constituting a significant health burden. We investigated only urban and suburban communities, the result may underestimate the real prevalence of the disease in China.