Chinese Youth Not Engaging in Heart Healthy Habits

Study is largest to look at health status, first to examine how socioeconomic factors impact heart health of Chinese children

Contact: Nicole Napoli,, 202-375-6523

WASHINGTON (Feb 15, 2022) -

Many children and adolescents in China have less than ideal cardiovascular health, including low rates of physical activity and unhealthy diet, according to a study in JACC: Asia. Socioeconomic factors including sex, education, family disease history and geographic location contribute to the lower overall percentage of youth engaging in positive heart health behaviors.

“Overall, we found that the prevalence of meeting all seven ideal metrics or all four ideal health behaviors was alarmingly low,” said Jin Jing, MD, PhD, senior author of the study, Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou, China, in the paper. “The findings among youths would be important for developing cardiovascular health promotion strategies.”

Cardiovascular disease is the leading cause of death worldwide. Despite cardiovascular disease death rates improving, in China, cardiovascular disease still accounts for 42% of deaths in urban areas and 45% of deaths in rural areas. Cardiovascular disease death most often impacts the elderly and symptoms of cardiovascular disease typically show up in middle age; however, the beginnings of poor cardiovascular health begin at a young age. There is a lack of data on the cardiovascular health status of children and adolescents in China and very few studies have looked at if the impact of socioeconomic factors on cardiovascular health is similar for children as it is for adults.

In one of the first studies of its kind, researchers looked at pre-defined ideal cardiovascular health behaviors in children and adolescents to determine overall cardiovascular health and associations between heart health and sociodemographic factors. Data from over 15,000 participants aged 7-17 years old who were part of a Chinese national intervention program against obesity were analyzed using four health behaviors: non-smoking, body mass index, physical activity and diet, and three health factors: total cholesterol, blood pressure and fasting plasma glucose to determine cardiovascular health status.

Researchers found that only 1.9% of males and 1.6% of females had ideal cardiovascular health status. When broken down by components of health status, 3.3% of males and 3% of females exhibited ideal cardiovascular health behaviors and 52.4% of males and 54.9% of females exhibited ideal health factors. Fasting plasma glucose was the most highly prevalent health factor (94.4% of males and 97.4% of females), and ideal physical activity and diet had the lowest percentage (34.6% and 28.3% for males and 23.9% and 30.1% for females, respectively). Females, younger children, those in areas with undeveloped economies, those in the southern region and those with no family history of cardiovascular disease were associated with more ideal cardiovascular health metrics.

The researchers found the greatest discrepancy in determining ideal smoking status when they accounted for passive smoking. The rate of nonsmoking in children and adolescents was 98.7%; however, when factoring the passive smoking, that percentage dropped by more than half.

The researchers said they recommend strategies such as household smoking control, eliminating food deserts in undeveloped regions of the country, programs to monitor and promote physical activity, and more studies to further explore how sociodemographic determinants impact cardiovascular health.

In an accompanying editorial comment, Jing Liu, MD, PhD, Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, said the research shows that the situation is alarming.

“These findings clearly indicate that the majority of the Chinese children and adolescents did not meet optimal levels of cardiovascular health,” Liu said. “Without effective interventions to promote cardiovascular health and reduce health disparities in early life, the success in improving the status of cardiovascular health in adulthood and reducing the burden of cardiovascular disease in the near future seems uncertain.”

Learn more about JACC: Asia at

For a copy of any of the papers in JACC: Asia or to receive embargoed access to all issues of JACC: Asia, contact Sam Roth at

The American College of Cardiology envisions a world where innovation and knowledge optimize cardiovascular care and outcomes. As the professional home for the entire cardiovascular care team, the mission of the College and its 54,000 members is to transform cardiovascular care and to improve heart health. The ACC bestows credentials upon cardiovascular professionals who meet stringent qualifications and leads in the formation of health policy, standards and guidelines. The College also provides professional medical education, disseminates cardiovascular research through its world-renowned JACC Journals, operates national registries to measure and improve care, and offers cardiovascular accreditation to hospitals and institutions. For more, visit

The ACC’s family of JACC Journals rank among the top cardiovascular journals in the world for scientific impact. The flagship journal, the Journal of the American College of Cardiology (JACC) — and family of specialty journals consisting of JACC: Advances, JACC: Asia, JACC: Basic to Translational Science, JACC: CardioOncology, JACC: Cardiovascular Imaging, JACC: Cardiovascular Interventions, JACC: Case Reports, JACC: Clinical Electrophysiology and JACC: Heart Failure — pride themselves on publishing the top peer-reviewed research on all aspects of cardiovascular disease. Learn more at


< Back to Listings