REFERENCES
1. United Nations. Department of economic and social affairs population division; 2024. Available from: https://population.un.org/wpp/downloads?folder=Standard%20Projections&group=Population [Last accessed on 28 Aug 2026].
2. Center for Cardiovascular Diseases the Writing Committee of the Report on Cardiovascular Health and Diseases in China. Report on cardiovascular health and diseases in China 2023: an updated summary. Biomed Environ Sci. 2024;37:949-92.
3. China NBoSo. China statistical yearbook 2025. China Statistics Press; 2025. Available from: https://www.stats.gov.cn/sj/ndsj/2025/indexeh.htm [Last accessed on 28 Aug 2026].
4. Hai L, Cui Y, Zhang J, Wang R. The dynamic equilibrium between population aging and the allocation of elderly medical care resources in the Yellow River Basin. BMC Public Health. 2025;25:2510.
5. Yuan D, Yang P, Yang H, Tang H, Guo C. Challenges and responses of left-behind elderly and children in rural China amid the new population development stage. China CDC Wkly. 2023;5:609-13.
6. Xiao Y, Zhang Z, Xu C, et al. Evolution of physician resources in China (2003-2021): quantity, quality, structure, and geographic distribution. Hum Resour Health. 2025;23:15.
7. Zhao Y, Atun R, Oldenburg B, et al. Physical multimorbidity, health service use, and catastrophic health expenditure by socioeconomic groups in China: an analysis of population-based panel data. Lancet Global Health. 2020;8:e840-9.
8. Xing W, Wang S, Liu X, et al. Prevalence and management of hypertension in central China: a cross-sectional survey. J Int Med Res. 2023;51:03000605221148905.
9. Zhang M, Wu J, Zhang X, et al. Prevalence and control of hypertension in adults in China, 2018. Zhonghua Liu Xing Bing Xue Za Zhi. 2021;42:1780-9.
10. Xinhua News Agency. China expands elderly care initiatives amid population ageing. Beijing: The State Council of the People's Republic of China. 2025. Available from: https://english.www.gov.cn/news/202412/31/content_WS67732aebc6d0868f4e8ee622.html [Last accessed on 25 Aug 2026].
11. Wang H, Chai K, Du M, et al. Prevalence and incidence of heart failure among urban patients in China: a national population-based analysis. Circ Heart Fail. 2021;14:e008406.
12. Zhang Z, Yue G, Wang L. RETRACTED: analysis of disease burden and future trends of ischemic heart disease in China and globally, 1990-2023. PLoS ONE. 2025;20:e0333927.
13. Xu S, Li Y, Lin F, Zuo P, Fan J, Yang X. Epidemiological trends in the burden of atrial fibrillation and atrial flutter in China (1990-2023). Vessel Plus. 2026;10:32.
14. Triposkiadis F, Butler J, Abboud FM, et al. The continuous heart failure spectrum: moving beyond an ejection fraction classification. Eur Heart J. 2019;40:2155-63.
15. Qi Y, Li J, Yang Z, Liu J, Zhao D. Cardiovascular disease in China: epidemiological evolution and implications. Eur Heart J. 2026;47:3544-54.
16. Li X, Krumholz HM, Yip W, et al. Quality of primary health care in China: challenges and recommendations. Lancet. 2020;395:1802-12.
17. Wang R, Wang Y, Lu J, et al. Forecasting cardiovascular disease risk and burden in China from 2020 to 2030: a simulation study based on a nationwide cohort. Heart. 2025;111:205-11.
18. Goyal P, Zainul O, Marshall D, Kitzman DW. Geriatric domains in patients with heart failure with preserved ejection fraction. Cardiol Clin. 2022;40:517-32.
19. Goyal P, Maurer MS, Roh J. Aging in heart failure: embracing biology over chronology: JACC family series. JACC Heart Fail. 2024;12:795-809.
20. Unlu O, Levitan EB, Reshetnyak E, et al. Polypharmacy in older adults hospitalized for heart failure. Circ Heart Fail. 2020;13:e006977.
21. Gorodeski EZ, Goyal P, Hummel SL, et al. Domain management approach to heart failure in the geriatric patient: present and future. J Am Coll Cardiol. 2018;71:1921-36.
22. Navid P, Nguyen L, Jaber D, et al. Attitudes toward deprescribing among adults with heart failure with preserved ejection fraction. J Am Geriatr Soc. 2021;69:1948-55.
23. Damluji AA, Nanna MG, Rich MW. Optimal management of HFpEF in very old patients: where do we stand? JACC Heart Fail. 2025;13:102758.
24. Goyal P, Zainul O, Sharma Y, et al. Geriatric vulnerabilities among adults with heart failure with preserved ejection fraction: a cross-continent evaluation. JACC Adv. 2025;4:101602.
25. National Clinical Research Center for Interventional Medicine, National Health Commission. Data report on percutaneous coronary intervention (PCI) in mainland China 2023; 2024. Available from: https://www.drvoice.cn/v2/article/12936 [Last accessed on 28 Aug 2026].
26. Li X, Murugiah K, Li J, et al. 10 year trends in urban-rural disparities in treatments and outcomes after ST-elevation myocardial infarction in China: insights from the China PEACE-Retrospective Acute Myocardial Infarction Study. Lancet. 2015;386:S2.
27. Shen C, Li C, Wang J, et al. In-depth look into urban and rural disparities in prehospital delay in patients with acute ST-elevation myocardial infarction and its impact on prognosis: a prospective observational study. BMJ Open. 2022;12:e063795.
29. Shi S, Tang Y, Zhao Q, et al. Prevalence and risk of atrial fibrillation in China: a national cross-sectional epidemiological study. Lancet Reg Health West Pac. 2022;23:100439.
30. Xia Z, Dang W, Yang X, et al. Prevalence of atrial fibrillation and the risk of cardiovascular mortality among hypertensive elderly population in northeast China. J Clin Hypertens. 2022;24:630-7.
31. Zhang SY. Chinese guidelines for the diagnosis and treatment of heart failure 2024. J Geriatr Cardiol. 2025;22:277-331.
32. Yang Y, Wang Z, Chen Z, et al. Current status and etiology of valvular heart disease in China: a population-based survey. BMC Cardiovasc Disord. 2021;21:339.
33. He SF, Jiang JR, Liu FZ, et al. Prevalence and modifiable risk factors of degenerative valvular heart disease among elderly population in southern China. J Geriatr Cardiol. 2021;18:523-33.
34. Pan WZ, Fang YX, Li J, et al. Transcatheter aortic valve replacement (TAVR) annual report 2023. Chin J Clin Thorac Cardiovasc Surg. 2024;31.
35. Wei L, Wang B, Yang Y, et al. Transcatheter aortic valve replacement in China - a review of the available evidence. AsiaIntervention. 2024;10:110-8.
36. Xie CM, Yao YT. The current practice of transcatheter aortic valve replacement in China. J Card Surg. 2022;37:3168-77.
37. Yang X, Zhao Z, Shi Y, et al. The evolving burden of heart failure in China: a 34-year subnational analysis of trends and causes from the Global Burden of Disease Study 2023. Mil Med Res. 2025;12:65.
38. Neal B, Wu Y, Feng X, et al. Effect of salt substitution on cardiovascular events and death. N Engl J Med. 2021;385:1067-77.
39. Zhang X, Yuan Y, Li C, et al. Effect of a salt substitute on incidence of hypertension and hypotension among normotensive adults. J Am Coll Cardiol. 2024;83:711-22.
40. Wang Y, Feng L, Zeng G, et al. Effects of cuisine-based Chinese heart-healthy diet in lowering blood pressure among adults in China: multicenter, single-blind, randomized, parallel controlled feeding trial. Circulation. 2022;146:303-15.
41. Ma J, Ma L, Lu S, Sun Y, Bao H. The effect of traditional Chinese exercises on blood pressure in patients with hypertension: a systematic review and meta-analysis. Evid Based Complement Alternat Med. 2023;2023:2897664.
42. Dai L, Jiang Y, Wang P, Chen K. Effects of three traditional Chinese fitness exercises combined with antihypertensive drugs on patients with essential hypertension: a systematic review and network meta-analysis of randomized controlled trials. Evid Based Complement Alternat Med. 2021;2021:1-14.
43. Ou K, Wong MYC, Chung PK, Chui KYK. Effect of square dance interventions on physical and mental health among Chinese older adults: a systematic review. Int J Environ Res Public Health. 2022;19:6181.
44. Lazo Green K, Yang Y, Abaraogu U, et al. Effectiveness of dance interventions for falls prevention in older adults: systematic review and meta-analysis. Age Ageing. 2024;53:afae104.
45. Yu K, Qiu G, Chan K, et al. Association of solid fuel use with risk of cardiovascular and all-cause mortality in rural China. JAMA. 2018;319:1351.
46. Xu J, Wang Q, Anikeeva O, Zhu P, Bi P, Huang C. Effects of extreme heat on physiology, morbidity, and mortality under climate change: mechanisms and clinical implications. BMJ. 2025;391:e084675.
47. Jia Y, Lee S, Kanda M, et al. Sustainable age-friendly cities and communities in China: a scoping review and narrative assessment of national policies. Lancet Reg Health West Pac. 2025;64:101723.
48. Jin C, Zhang Y, Wang B, Hua P. Influenza vaccination and cardiovascular and respiratory outcomes in high-risk populations: an umbrella review of systematic reviews and meta-analyzes. Front Immunol. 2026;17:1798398.
49. Fröbert O, Götberg M, Erlinge D, et al. Influenza vaccination after myocardial infarction: a randomized, double-blind, placebo-controlled, multicenter trial. Circulation. 2021;144:1476-84.
50. Anderson CS, Hua C, Wang Z, et al. Influenza vaccination to improve outcomes for patients with acute heart failure (PANDA II): a multiregional, seasonal, hospital-based, cluster-randomised, controlled trial in China. Lancet. 2025;406:1020-31.
51. Castellano JM, Pocock SJ, Bhatt DL, et al. Polypill strategy in secondary cardiovascular prevention. N Engl J Med. 2022;387:967-77.
52. World Health Organization. The selection and use of essential medicines 2023. Geneva: WHO; 2023. Available from: https://iris.who.int/server/api/core/bitstreams/f8f65796-ca38-4bc3-9833-af6edf4f5669/content [Last accessed on 28 Aug 2026].
53. Xu Y, Li X, Zhang H, et al. China Tongxinluo Study for myocardial protection in patients with Acute Myocardial Infarction (CTS-AMI): rationale and design of a randomized, double-blind, placebo-controlled, multicenter clinical trial. Am Heart J. 2020;227:47-55.
54. Hao P, Jiang F, Cheng J, Ma L, Zhang Y, Zhao Y. Traditional Chinese medicine for cardiovascular disease: evidence and potential mechanisms. J Am Coll Cardiol. 2017;69:2952-66.
55. Yang Y, Li X, Chen G, et al. Traditional Chinese medicine compound (Tongxinluo) and clinical outcomes of patients with acute myocardial infarction: the CTS-AMI randomized clinical trial. JAMA. 2023;330:1534.
56. Cheang I, Yao W, Zhou Y, et al. The traditional Chinese medicine Qiliqiangxin in heart failure with reduced ejection fraction: a randomized, double-blind, placebo-controlled trial. Nat Med. 2024;30:2295-302.
57. Butt JH, Jhund PS, Belohlávek J, et al. Efficacy and safety of dapagliflozin according to frailty in patients with heart failure: a prespecified analysis of the DELIVER trial. Circulation. 2022;146:1210-24.
58. Coats AJ, Butler J, Tsutsui H, et al. Efficacy of empagliflozin in heart failure with preserved ejection fraction according to frailty status in EMPEROR-Preserved. J Cachexia Sarcopenia Muscle. 2023;15:412-24.
59. Sun Y, Mu J, Wang DW, et al. A village doctor-led multifaceted intervention for blood pressure control in rural China: an open, cluster randomised trial. Lancet. 2022;399:1964-75.
60. He J, Ouyang N, Guo X, et al. Effectiveness of a non-physician community health-care provider-led intensive blood pressure intervention versus usual care on cardiovascular disease (CRHCP): an open-label, blinded-endpoint, cluster-randomised trial. Lancet. 2023;401:928-38.
61. Zhang X, Wang S, Zhou X, et al. A village doctor-led mobile health intervention for cardiovascular risk reduction in rural China: cluster randomised controlled trial. BMJ. 2025;389:e082765.
62. Song J, Wang X, Wang B, et al. Learning implementation of a guideline based decision support system to improve hypertension treatment in primary care in China: pragmatic cluster randomised controlled trial. BMJ. 2024;386:e079143.
63. Levine GN, Cohen BE, Commodore-Mensah Y, et al. Psychological health, well-being, and the mind-heart-body connection: a scientific statement from the American Heart Association. Circulation. 2021;143:e763-83.
64. Han L, Shen S, Wu Y, Zhong C, Zheng X. Trajectories of depressive symptoms and risk of cardiovascular disease: evidence from the China health and retirement longitudinal study. J Psychiatr Res. 2022;145:137-43.
65. Yip W, Fu H, Chen AT, et al. 10 years of health-care reform in China: progress and gaps in universal health coverage. Lancet. 2019;394:1192-204.
66. Feng Z, Liu C, Guan X, Mor V. China’s rapidly aging population creates policy challenges in shaping a viable long-term care system. Health Aff. 2012;31:2764-73.
67. Feng Z, Glinskaya E, Chen H, et al. Long-term care system for older adults in China: policy landscape, challenges, and future prospects. Lancet. 2020;396:1362-72.
68. Fang EF, Fang Y, Chen G, et al. Adapting health, economic and social policies to address population aging in China. Nat Aging. 2025;5:2176-87.
69. Global Health Data Exchange (GHDx). Global Burden of Disease Study; 2023. Available from: https://ghdx.healthdata.org/gbd-2023 [Last accessed on 25 Aug 2026].
70. Wang L, Peng W, Zhao Z, et al. Prevalence and treatment of diabetes in China, 2013-2018. JAMA. 2021;326:2498.





