It is well known that the ageing process starts in the blood vessels, and that the global prevalence of cardiovascular disease (CVD) is steadily increasing in line with the ageing population and lifestyle changes. The prevalence of CVD has also rapidly increased among the populations of the Asia-Pacific region over the past few decades. Meanwhile, remarkable advances in cardiology and healthcare for CVD patients have contributed to a reduction in mortality from CVD.
Half a century ago, in the Asia-Pacific region the burning issue was to overcome infections, and a major mission in healthcare was to prevent tropical disease and tuberculosis. Today, however, infections have been largely brought under control, excluding emerging infections. Accordingly, life expectancy has increased by more than 20 years during this period of time. In the history of mankind, such an increase in such a short space of time is an unprecedented phenomenon. Ageing populations are greatly driven by improvements to the living environment, food situations and medical resources. As the importance of CVD as a cause of death increases, the control of CVD is becoming the greatest mission in healthcare in the Asia-Pacific region, as well as in the West. However, there are still large variations in economic and living standards among the countries of this region. Types of diseases and quality of healthcare differ among countries accordingly; the prevalence rates of diseases, quality of healthcare and access of people to healthcare also differ greatly because of differences in the genetic, economic and social backgrounds of the various ethnic populations.
Recently, the value of evidence-based medicine has been emphasised. However, there is no satisfactory evidence specific to the populations in the Asia-Pacific region. Various medical guidelines have been established in the US, Europe, Australia, etc., as well as in Japan. These guidelines have contributed to the standardisation of healthcare by providing gold standards of treatment. However, although standard healthcare should ideally be available globally, the feasibility of healthcare depends on medical resources and medical infrastructure, e.g. access to healthcare. These issues include aspects that are difficult to achieve simply by the individual efforts of cardiologists. Instead, healthcare should be positioned in the process of creating social systems. Although governmental policy for healthcare is important, cardiologists should also consider their role – what have we done so far and what can we do in the future? A large number of medical professionals in the Asia-Pacific region may have had experience of Western healthcare and medical research in their youth.
Their experience and knowledge, transmitted to the next generation, have contributed to the improvement of healthcare in the region. Unfortunately, however, satisfactory cross-communication among Asia-Pacific countries is lacking. It is therefore necessary to promote mutual understanding and exchanges of technology among countries or regions, to perform collaborative epidemiology studies and to establish regional evidence.
Each and every one of us is required to exert further efforts to diffuse advanced medical technology, exchange medical knowledge and improve medical infrastructure to promote unified healthcare in the Asia-Pacific region. We should fully recognise the importance – and contribute to the realisation – of a lively community with more youthful energy and mutual collaboration.
This inaugural edition of Asia-Pacific Cardiology brings together a wide variety of review articles covering the whole spectrum of the discipline. I hope that it proves useful in assisting in the dissemination of cardiovascular knowledge and clinical experience across the region.