Altitudinal, Temporal and Spatial Distribution of Cardiovascular Disease Incidence in Four Western Provinces (Guizhou, Qinghai, Sichuan and Yunnan) of China, 2023–2024

Zhuo Wang; Qian Ren; Xin Wang; Congyi Zheng; Xuyan Pei; Qinglan Jia; Yujin He; Yuxin Zha; Xiaoyun Qin; Yaqi Liu; Rui He; Kui Ji; Bo Zhong; Zengwu Wang

doi:10.53941/icirculation.2026.100012

Abstract

Background: Western China, characterized by high altitude, hypoxia, cold climate, and large seasonal temperature variations, exhibits a high level of cardiovascular disease (CVD) incidence, yet the underlying environmental risk factors remain poorly understood. Methods: CVD data were obtained from the national surveillance database managed by the National Center for Cardiovascular Diseases, China. Disease burden was assessed using incidence rate and age-standardized incidence rate (ASIR). Spatial autocorrelation was evaluated using Global Moran’s I, and a generalized linear model (GLM) was employed for multivariable analysis. Results: The overall ASIR decreased from 600.21 per 100,000 in 2023 to 531.92 per 100,000 in 2024. Regional variation was evident, with Yunnan showing consistently higher incidence and Qinghai exhibiting the lowest survival. Stroke accounted for the largest proportion of CVD burden. Males and older individuals had higher incidence levels, while seasonal peaks occurred in spring and winter. Descriptive analyses suggested differences in incidence across altitude strata, but multivariable regression revealed no independent association between altitude and CVD incidence. Conclusions: CVD incidence in western China varies by region, season, and population, with stroke predominating. Higher rates occur in males and the elderly, highlighting the need for targeted prevention strategies and strengthened primary healthcare services.

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