Primary Prevention of Cardiovascular Disease in Asia: Challenges: A Narrative Review

Dalakoti M 1 , Lin NHY 2 , Yap J 3 , Cader A 4 , Dipanker P 5 , Lee D 6 Show all authors , Raja Shariff RE 7 , Cuenza L 8 , Honda S 9 , Malis V 10 , Jiang H 11 , Hirachan A 12 , Chimura M 13 , Yeo TJ 2 , Yeo KK 3 , Tan JWC 3 , Tromp J 14 , Loh PH 2 , Chew NWS 15 , Wong S 2 , Sia CH 15 , Tan BYQ 16 , Johar S 17 , Lip GYH 18 , Yang E 19 , Virani SS 20 , Hageman S 21 , Liu H 22 , Di Angelantonio E 23 , Dorairaj P 24 , Koh AS 16 , Chin C 16 , Al Mahmeed W 25 , Chan MY 15 , Foo R 15

Affiliations 

  • 1 Department of Cardiology, National University Heart Centre, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom. Electronic address: mayank_dalakoti@nuhs.edu.sg
  • 2 Department of Cardiology, National University Heart Centre, Singapore
  • 3 Department of Cardiology, National Heart Centre Singapore, Singapore; Duke-NUS Medical School, Singapore
  • 4 Department of Cardiology, Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh
  • 5 Department of Cardiology, Shahid Gangalal National Heart Centre, Kathmandu, Nepal
  • 6 Department of Cardiology, Queen Elizabeth Hospital, Hong Kong, Hong Kong
  • 7 Department of Cardiology, Universiti Teknologi MARA, Selangor, Malaysia
  • 8 Department of Cardiology, Philippines Heart Centre, Quezon City, Philippines
  • 9 Department of Cardiology, National Cerebral and Cardiovascular Centre, Suita, Osaka, Japan
  • 10 Department of Cardiology, Intercare Medical Centre, Phnom Penh, Cambodia
  • 11 Lee Kong Chian School of Medicine, Singapore
  • 12 Department of Cardiology, Mediciti Hospital Nepal, Lalitpur, Nepal
  • 13 Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Osaka, Japan
  • 14 Yong Loo Lin School of Medicine, National University of Singapore, Singapore; Saw Swee Hock School of Public Health & the National University Health System, National University of Singapore, Singapore
  • 15 Department of Cardiology, National University Heart Centre, Singapore; Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 16 Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 17 Department of Cardiology, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei
  • 18 Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John. Moores University and Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
  • 19 Division of Cardiology, University of Washington School of Medicine, Seattle, USA
  • 20 Department of Medicine, The Aga Khan University, Karachi, Pakistan; Section of Cardiovascular Research, Baylor College of Medicine, Houston, Texas, USA
  • 21 University Medical Center Utrecht, Utrecht, the Netherlands
  • 22 The George Institute for Global Health, Sydney, Australia
  • 23 Department of Public Health and Primary Care, University of Cambridge, Cambridge, United Kingdom
  • 24 Center for Chronic Disease Control India, Delhi, India
  • 25 Heart and Vascular Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, UAE
JACC Adv, 2025 Mar 20;4(4):101670.
PMID: 40117691 DOI: 10.1016/j.jacadv.2025.101670

Abstract

IMPORTANCE: Asia is home to 60% of the world's population, including the world's two most populous countries, India (1.1B) and China (1.2B). With cardiovascular disease burden and mortality increasing, the role of preventive cardiology is increasingly important.

OBSERVATIONS: The challenges in addressing the cardiovascular disease burden in Asia include unique cardiometabolic features of the different populations, heterogeneity of risk factors among Asian countries, differing levels of health literacy and socioeconomic status, suboptimal infrastructure to support preventive care especially in the primary care sector, high out-of-pocket costs, and environmental pollution.

CONCLUSIONS: Asia is a large continent that comprises diverse populations with varying cultures, socioeconomic status, and health literacy levels. Effective preventive cardiology may require differential health care resource allocation and financing models.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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