Robert Detrano，China California Heart Watch，USA.

<International Circulation>：What is the main factor for the accelerated epidemic of heart disease in China?

Prof. Detrano：There are many factors. It is very difficult to identify one， certainly， the changes in life style is extremely important general factor. It includes changes in diet， increase in salt intake- Dr. Wu Yangfeng is discussing it， increase in calorie intake， increase intake in fats and fatty foods and also decreased exercise and physical activities. These are the problems now in the city and also in the country. Smoking increased very rapidly， as said in the first presentation today， so there was an increase in smoking in China until 1990s， now it seems to be better， but I’m very concerned about potential increase in smoking in China， particularly in women， this is we know only 4% of Chinese women smoke now. But there are tobacco industries trying very hard to increase the number of smoking women. So I think all of these factors are very important in the increase of cardiovascular disease in China.

<International Circulation>：How do you evaluate the efforts made by our Chinese doctors and Chinese counterparts in the prevention and treatment of heart disease?

Prof. Detrano：I think Chinese doctors and Chinese academic professors were making very very important efforts， or making heroic efforts in the field， particularly Dr. Wu yangfeng， who was very very active， very busy in this field. At China Medical University， Shen Yang， Dr. Sun Ying Xian，  went to the countryside， to the farms， worked for long period of time， worked with the farmers and evaluated high blood pressure and treated high blood pressure. Dr. Hu Dayi， from Beijing University， has also been very active in this field， and has dedicated most of his life to this field in recent years. I think Chinese doctors are doing a lot， but there are still a lot to be done.

<International Circulation>：Would you please give us some advice for the therapies on prevention of cardiovascular disease?

Prof. Detrano：I think the best advice is to look at the cardiovascular risk factors what we know are and try to decrease the intensity of the risk factors， particularly for the high blood pressure. Dr Wu talked about salt. Decrease in the salt intake in the diet is very very important， both in the dietary decrease in salt intake in food and additives， or perhaps using other methods， like salt substitute. Quit smoking， it’s extremely important， particularly in Chinese men， right now， about 70% of Chinese men still smoke. This needs to be decreased. So this is a big problem I think， probably a big problem in the rural area than in the city. Increases in physical activity， people have to learn how to get back to their bicycle， and get out of their cars. And physical activity also decreases cardiovascular disease. I think all of these things are very very important in changes in lifestyle and decrease the chances of getting heart attacks， strokes and etc.