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According to the World Health Organization (WHO) report, an estimated 17 million people die of cardiovascular diseases each year. Globally, cardiovascular diseases – including stroke – are the number one cause of death, representing 30% of all deaths worldwide. An increasing burden of heart disease and stroke is also seen in Asia- Pacific countries. It should be noted that about 80% of cardiovascular deaths now occur in low- and middle-income countries. Thus, the weight of the burden of this abnormality is also increasing in Asia-Pacific countries owing to ageing population and changes in life-style.

In advanced countries in this region, an older population structure is a notable trend. In the 1960s, population distribution formed a pyramid shape with a high fertility rate and relatively short life expectancy. However, age-group distribution is now shaped more like a bell due to low fertility rates and extended life expectancy. In Japan and the Republic of Korea, a low fertility rate and an ageing population have emerged as serious social problems; in ageing societies an increase in cardiovascular disease is inevitable and has a critical impact on healthcare, since the ageing process is always linked with cardiovascular senility.

In contrast, in growing countries in the Asia-Pacific region, such as China, healthcare is facing another big challenge: the unprecedented economic and social changes seen in recent years. The disease burden has largely shifted from communicable to non-communicable diseases: cardiovascular disease, cancer and injuries have become the leading causes of mortality and morbidity. In developing countries, infectious diseases are still high burdens: tuberculosis and respiratory infections in children and the young are not yet controlled. However, the burden of cardiovascular disease is increasing owing to changes in lifestyle and diet in these countries. Thus, cardiovascular disease is increasing globally, and healthcare for this abnormality will be a worldwide challenge, requiring standardisation of healthcare and preventative medicine.

Recently, big progress has been seen in the treatment of cardiovascular diseases with various technologies as well as drugs, including intravascular therapy using a catheter technique, e.g. intravascular ultrasound (IVUS), debulking devices and various stents. Non-invasive imaging by dynamic scanning of the heart and vessels with multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) is also a rapidly growing area. New devices for the treatment of advanced heart failure, e.g. implantable cardiac defibrillators (ICDs), left ventricular assist devices (LVAD), cardiac resynchronisation therapy (CRT) and multifunctional pacemakers, are also widely provided all over the world. However, we need to make further efforts to provide advanced medical technology, exchange medical knowledge and improve medical infrastructure to promote unified healthcare in the Asia-Pacific region.

This edition of Asia-Pacific Cardiology brings together a wide variety of review articles covering the broad spectrum of the discipline. I hope that it it is a useful source of information for cardiologists not only in the Asia-Pacific region but also in other areas of the world.