To the Editor Approximately 93% of the population in low- and middle-income countries lacks access to safe, timely, and affordable cardiac surgical care when needed, which translates to 1.29 billion people in China.1 China is an upper middle–income country undergoing significant epidemiological transition, with a gradual decrease in infectious diseases but rapid increase in noncommunicable diseases. Conditions such as rheumatic heart disease remain prevalent and burdensome, while ischemic heart disease and stroke affect millions across the country.2
Vervoort D, Ma X, Luc JGY. Addressing the Cardiovascular Disease Burden in China—Is It Possible Without Surgery? JAMA Cardiol. 2019;4(9):952–953. doi:10.1001/jamacardio.2019.2433
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