Addressing Cardiovascular Diseases Challenges in South Korea: Strategies to Improve Outcomes

Abstract

Cardiovascular diseases (CVDs) pose a significant public health challenge in South Korea. This paper attempts to assess the current status of major cardiovascular risk factors and representative CVDs, and proposes policies and strategies to improve CVDs outcomes. It addresses key issues related to hypertension, dyslipidemia, ischemic heart disease, atrial fibrillation, sudden cardiac death, heart failure and valvular heart disease. The high-priority strategies for improving CVDs outcomes include raising public awareness, emphasizing prevention, ensuring equitable access to care, increasing investment in CVDs research, enhancing healthcare provider education, and incentivizing care for high-risk patients care. To implement those strategies, this paper proposes policies for both government and academic societies.

Keywords: Cardiovascular diseases; Health education; Health equity; Health policy; Research; Secondary prevention.

Figure 1. Relationship between stroke mortality rate in each decade of age and usual BP at the start of that decade.

BP = blood pressure; CI = confidence interval.

Figure 2. Attribution of hypertension and other cardiovascular risk factors for the coronary artery disease (A) and cerebrovascular diseases (B) in Korean male population (Korean Medical Insurance Corporation study).

Figure 3. LDL-cholesterol goal attainment rates in high-risk patients by target LDL-cholesterol level.

Adapted from Yang et al. Lipids Health Dis 2020;19:5. LDL = low-density lipoprotein

Figure 4. LDL-cholesterol goal attainment rates in high-risk patients by LDL-cholesterol reduction rate.

Adapted from Yang et al. Lipids Health Dis 2020;19:5. LDL = low-density lipoprotein.

Figure 5. The number of certified physicians under 65 and the ratio of the elderly population (65 and older) to certified physicians, categorized by administrative districts in Korea.

Figure 6. Projected prevalence rate of atrial fibrillation.

Adapted from Kim et al. Am Heart J 2018;202:20-6.

Figure 7. Annual trends in age- and sex-adjusted incidence of out-of-hospital cardiac arrest per 100,000 person-years.

Adapted from Roh et al. Korean Circ J 2021;51:866-74.

Figure 8. Annual age-related distribution of sudden cardiac arrest incidence per 100,000 person-years.

Adapted from Roh et al. PLoS One 2020;15:e0242799.

Figure 9. Summary of heart failure statistics.

Source: The Korean Society of Heart Failure, 2022 Korean Heart Failure Fact Sheet.

Figure 10. Age-specific prevalence of heart failure.

Source: The Korean Society of Heart Failure, 2022 Korean Heart Failure Fact Sheet.

Figure 11. Mortality rate among patients with heart failure.

Source: The Korean Society of Heart Failure, 2022 Korean Heart Failure Fact Sheet.

Figure 12. The types of valvular heart disease by age group.

Source: Choi et al. J Cardiovasc Imaging 2023;31:51-61. AR = aortic regurgitation; AS = aortic stenosis; MR = mitral regurgitation; MS = mitral stenosis; TR = tricuspid regurgitation.

Figure 13. Etiology of each valvular heart disease. Pie charts showing the distribution of the etiology of mitral stenosis (A), primary mitral regurgitation (B), secondary mitral regurgitation (C), aortic stenosis (D), aortic regurgitation (E), and tricuspid regurgitation (F) in Korea.

Source: Choi et al. J Cardiovasc Imaging 2023;31:51-61.

Figure 14. The ideal patient pathway for valvular heart disease.

Adapted from Sitges et al. Eur Heart J Open 2021;1: oeab034. Written permission has been obtained from the copyright holder for its use in this publication.