Is hypertension a leading cause of heart failure in Chinese?

1. There is considerable uncertainty regarding the importance of various risk factors in the development of heart failure. Most data are from Caucasian populations, where hypertension and coronary artery disease appear dominant. 2. Because it cannot be presumed that risk factor profiles will be identical for all races, we reviewed the literature on the aetiology of heart failure in Chinese. 3. There are, apparently, no long-term prospective studies defining the risk factors for heart failure in Chinese. Studies from Hong Kong in the 1990s point to an overlap of risk factors (especially hypertension, ischaemic heart disease and diabetes) and a high prevalence of diastolic heart failure (66%). Antihypertensive drug treatment appears likely to protect against the development of heart failure but end-points from formal trials are too small to be certain. 4. Available data, short of being definitive, point to hypertension being the most important identifiable risk factor in Chinese with heart failure. This may change with diabetes mellitus becoming more prevalent in the Chinese population.