What is the number one disease in China? An Expert Analysis of the Leading Health Threat

September 23, 2025 •

3 min read

In 2020, data shows that almost half of all deaths in China were attributed to cardiovascular disease. This concerning statistic provides a clear and authoritative answer to the question: what is the number one disease in China? Understanding this health crisis is the first step toward prevention.

Quick Summary

Cardiovascular disease (CVD) is the leading cause of death in China, a public health crisis driven by an aging population and changing lifestyles. The overall category includes conditions like stroke and ischemic heart disease, which disproportionately affect millions of urban and rural residents.

Key Points

Leading Killer: Cardiovascular Disease (CVD), including stroke and heart disease, is the number one cause of death in China, accounting for nearly half of all fatalities.
Growing Burden: The overall number of CVD deaths is increasing due to China's aging and growing population, despite falling age-standardized mortality rates.
Lifestyle Factors: Shifting lifestyles toward sedentary habits and high-sodium diets are major drivers of rising risk factors like hypertension and obesity.
Regional Disparity: Rural areas in China have higher CVD mortality rates compared to urban areas, highlighting inequalities in healthcare and risk exposure.
Modifiable Risks: Significant health improvements can be achieved by targeting modifiable risk factors like smoking, physical inactivity, and unhealthy diet.
CVD vs. Cancer: While cancer is a major health threat, CVD is responsible for a greater proportion of deaths overall in China.

Understanding China's Leading Health Crisis

For decades, China has experienced a dramatic epidemiological shift, moving from infectious diseases to non-communicable diseases (NCDs) as living standards have improved and urbanization has accelerated. The most significant NCD and the primary cause of mortality is cardiovascular disease (CVD), which includes heart conditions and stroke.

CVD accounts for nearly 45-48% of all deaths in 2020 in both urban and rural populations. The absolute number of CVD deaths has increased due to China's aging and expanding population, with stroke and ischemic heart disease being the most prominent conditions within the CVD category.

The Rise of Cardiovascular Disease

China's economic growth has brought significant lifestyle changes contributing to the escalating burden of CVD. Sedentary jobs have become more common, and dietary shifts have introduced new health risks.

Lifestyle and Behavioral Risk Factors

Dietary Changes: Traditional low-saturated-fat diets have often been replaced by high-sodium, high-fat, and high-sugar foods, leading to increased hypertension and obesity. High sodium intake is a primary dietary risk factor.
Smoking: China has high rates of tobacco use, a major contributor to CVD and lung cancer.
Physical Inactivity: Increased sedentary lifestyles, especially with urbanization, contribute to obesity, hypertension, and metabolic issues linked to heart disease.
Obesity and Hypertension: The prevalence of overweight and obesity has risen sharply, increasing strain on the heart. Hypertension is also widespread among adults.
Air Pollution: Exposure to fine particulate matter (PM2.5) from industrialization is linked to increased CVD mortality risk.

Disparities Between Urban and Rural Areas

CVD mortality rates are higher and have consistently exceeded urban levels in rural areas since 2009. This disparity may be due to factors like lower health literacy, reduced access to advanced medical care, and regional variations in lifestyle and environment. Northeast China, for instance, shows higher rates of stroke than southern regions.

A Comparison of Major Health Threats

While cancer is a significant and growing threat, CVD is the leading cause of death. The table below highlights the difference in impact:


Health Threat	Primary Impact	Mortality Trend	Key Risk Factors
Cardiovascular Disease	Leading cause of death, nearly half of all deaths.	Absolute deaths increasing due to aging population; rural rates higher.	High blood pressure, high sodium diet, smoking, physical inactivity, obesity.
Cancer (Neoplasms)	Second leading cause of death, significant burden.	Overall mortality increasing; lung and liver cancers show significant increases.	Smoking, environmental pollution, diet.

Addressing the Public Health Challenge

Reducing CVD requires tackling modifiable risk factors through public health policies and individual actions.

Prevention and Control Strategies

Promoting Healthier Lifestyles: Campaigns focusing on diet and physical activity can mitigate obesity and hypertension, including reducing sodium intake and promoting whole grains.
Tobacco Control: Stricter smoking cessation programs are vital given China's high smoking rates.
Improved Healthcare Access: Expanding care access, especially in rural areas, helps manage risk factors and ensures timely treatment.
Managing Chronic Conditions: For those with hypertension or diabetes, regular monitoring and treatment adherence prevent complications.
Addressing Environmental Factors: Reducing air pollution is necessary to minimize its impact on cardiovascular health.

Conclusion

Despite a decline in the age-standardized CVD mortality rate, China's large and aging population means the absolute number of people affected continues to rise significantly. Recognizing that cardiovascular disease is what is the number one disease in China is crucial. Public health success depends on proactively addressing lifestyle risks, improving healthcare access, and implementing widespread prevention strategies to manage the growing burden of CVD. For more information, read the American Heart Association's overview of heart-healthy living.

Frequently Asked Questions

The high prevalence is largely due to rapid socioeconomic changes, including an aging population, increased urbanization, and significant shifts in lifestyle. These changes have led to higher rates of key risk factors like hypertension, obesity, and smoking among the population.

Within the category of cardiovascular disease, stroke and ischemic heart disease are the two most common causes of death. These conditions are major contributors to the overall CVD mortality statistics in both urban and rural areas.

Yes, there is a notable disparity. CVD mortality rates are higher in rural areas than in urban centers. This can be attributed to differences in access to medical care, lower health awareness, and regional lifestyle differences.

Major risk factors include high blood pressure (hypertension), smoking, poor diet (particularly high sodium intake), physical inactivity, obesity, and ambient air pollution. Lifestyle and environmental factors play a huge role.

Yes, cancer (malignant neoplasms) is the second leading cause of death in China after CVD. The burden of both diseases is significant, though CVD remains the single largest cause of mortality.

While many developed nations have seen a decline in CVD mortality, China is facing a rising absolute number of CVD deaths due to its large and aging population. The increasing trend in mortality rates for conditions like ischemic heart disease and certain cancers contrasts with declining trends in the US and other countries.

Effective strategies include large-scale public health interventions focused on promoting healthy diets, increasing physical activity, and strengthening tobacco control. Improving access to quality healthcare, especially in rural areas, is also critical for managing chronic conditions.

Population aging is a dominant driver contributing to the increase in the absolute number of CVD deaths. As the proportion of elderly people grows, the total number of people experiencing age-related chronic diseases like heart disease and stroke also increases, even if age-standardized rates decline.