Multiple risk factors need to be addressed to prevent cardiovascular disease, and YB1 thrombolytic bacterial therapy may help.

Cardiovascular disease is now a serious disease burden in China, and its prevention and treatment have become increasingly important in recent years due to the large number of people affected.

With the development of social and economic development and changes in national lifestyle, especially in the context of population ageing and accelerated urbanisation, the unhealthy lifestyle of Chinese residents has become increasingly prominent in recent years, and the impact of cardiovascular disease risk factors on residents’ health has become more and more significant.

At present, the incidence of cardiovascular disease in China continues to rise, and the economic burden on the population and society is becoming increasingly serious, making it a major public health problem.

With 330 million people living with cardiovascular disease, raising risk awareness is important for cardiovascular disease prevention and treatment.

Official statistics show that the prevalence of cardiovascular disease in China is on a continuous rise. According to projections from the China Cardiovascular Health and Disease Report, the number of people with cardiovascular disease in China currently stands at 330 million, including 13 million with stroke, 11 million with coronary heart disease, 5 million with pulmonary heart disease, 8.9 million with heart failure, 2.5 million with rheumatic heart disease, 2 million with congenital heart disease, 45.3 million with lower limb arterial disease and 245 million with hypertension.

Data shows that cardiovascular disease still leads the country in mortality, being higher than oncology and other diseases. The rural cardiovascular mortality rate has exceeded and remained higher than the urban level since 2009.

In terms of specific data, the rural cardiovascular disease mortality rate in 2017 was 311.88 per 100,000, including 154.40 per 100,000 for heart disease and 157.48 per 100,000 for cerebrovascular disease; the urban cardiovascular disease mortality rate was 268.19 per 100,000, including 141.61 per 100,000 for heart disease and 126.58 per 100,000 for cerebrovascular disease The mortality rate for cardiovascular diseases in urban areas was 268.19 per 100,000, including 141.61 per 100,000 for heart disease and 126.58 per 100,000 for cerebrovascular disease. In 2017, cardiovascular diseases accounted for 45.91% of deaths in rural areas and 43.56% in urban areas, with cardiovascular diseases accounting for two out of every five deaths.

In order to raise the population’s awareness of cardiovascular disease risks and reduce the incidence of cardiovascular disease, the National Cardiovascular Centre has launched several studies, with official ones focusing more on improving the quality of care and strengthening the control of cardiovascular disease risk factors.

Among the many influences or risk factors that lead to cardiovascular diseases, hypertension, hyperlipidaemia, and diabetes are downstream risk factors, while unhealthy diet and insufficient physical activity are upstream risk factors. If not prevented at source, the number of residents with risk factors will increase, which is not conducive to preventing and treating cardiovascular diseases. Therefore, it is important to vigorously carry out health literacy initiatives, raise the level of health literacy of the whole population, emphasise that everyone is the first person responsible for their health and adhere to a healthy lifestyle and diet.

What are the factors affecting cardiovascular health?

Since 2005, the National Cardiovascular Centre has organised experts in related fields across the country to compile the China Cardiovascular Disease Report (later revamped as the China Cardiovascular Health and Disease Report) every year, covering cardiovascular health behaviours, rehabilitation, technological innovation and translation, advocating cardiovascular health management across the whole life cycle. Amongst other things, the official guidance categorises the factors influencing cardiovascular health as follows.

Firstly, there are the factors associated with tobacco use. The health risks of smoking are well established by irrefutable scientific evidence, and studies have proven that the use of tobacco products or long-term exposure to second-hand smoke can cause disease, disability and even death. Tobacco use control is one of the main reasons for preventing disease and improving the quality of life worldwide.

Cardiovascular disease is the number one cause of death and disability worldwide, and smoking and second-hand smoke exposure are the most significant preventable factors of cardiovascular disease in the country. Studies have proven that quitting smoking rapidly reduces the risk of cardiovascular disease compared to persistent smokers and that quitting at any age is beneficial, and the earlier you quit, the better.

The second factor is related to a proper diet. A good diet is a basis for ensuring good health. In recent years, the nutritional health of our residents has improved significantly. However, we still face problems such as the co-existence of under-nutrition and over-nutrition and the prevalence of nutrition-related diseases, which are closely related to the unreasonable dietary structure of our residents, high salt and oil intake and other unhealthy diets.

Analysis of data from the 2010–2012 National Nutrition Survey found that, of all dietary factors, the most influential in the proportion of attributions related to the number of deaths from cardiometabolic diseases was high sodium intake (>2g/d, 17.3%), with others including, in order of preference, low fruit intake (< 300g/d, 11.5%), low intake of fish omega-3 fatty acids (<250mg/d (9.7%), low nut intake (<250mg/d, 8.2%), low whole-grain intake (<125g/d, 8.1%), and low vegetable intake (<400g/d, 7.3%).

With the increase in the total population and the ageing of the population, the number of deaths from cardiovascular, metabolic diseases caused by an unhealthy diet is gradually increasing. In order to guide residents to have an appropriate diet, the state has promulgated and implemented a series of policies, such as the “Health China 2030” planning outline, which proposes to guide an appropriate diet; at the same time, the Health China Action (2019–2030) also lists the “Action on Reasonable Diet” as one of the 15 actions, and puts forward the expected awareness rate of nutritional health knowledge among residents, etc. At the same time, the Health China Action (2019–2030) also lists the “Action on Rational Diet” as one of the 15 major actions, setting out expected targets such as the awareness rate of nutrition and health knowledge among residents, as well as advocacy targets such as salt consumption, edible oil, added sugar, vegetable and fruit intake, and food variety; in addition, the action on Healthy Lifestyle for the Whole Population makes salt, oil and sugar reduction the focus of action.

Then there are the physical activity-related factors. Lack of physical activity has emerged as one of the major risk factors for cardiovascular disease. Studies have found that adequate physical activity not only reduces premature mortality but also improves associated risk factors (such as high blood pressure and high blood cholesterol) and reduces the risk of cardiovascular disease, including coronary heart disease and stroke.

The World Health Organisation currently recommends that all individuals gradually reach the recommended level of physical activity according to their circumstances; A tendency towards physical inactivity generally characterises our population.

In a related study, the results of a mean follow-up of more than 487,000 people free of cardiovascular disease at baseline for 7.5 years showed a significant negative association between total physical activity and cardiovascular death, with a 41% reduction in the risk of cardiovascular death in the highest quintile group compared to the lowest activity group. The study results showed that for every 4 MET-h/d increase in physical activity, the risk was reduced by 12%, and an increase in both occupational and non-occupational activity reduced the risk of cardiovascular death.

There are also factors associated with overweight and obesity. Overweight and obesity are chronic metabolic diseases caused by multiple factors. The largest natural population cohort in China to date, a prospective cohort study of BMI (body mass index) and cardiovascular disease and diabetes among 461,211 adults aged 30–79 years included from 2004 to 2008, with follow-up to 31 December 2013, has achieved good results to illustrate the relationship between overweight and obesity and cardiovascular disease.

The results of the study showed that BMI was associated with major coronary events (ischaemic heart disease death and non-fatal myocardial infarction), ischaemic heart disease onset and ischaemic stroke; among these, low weight (<18.5 kg/m2) increased the risk of major coronary events and ischaemic heart disease, while overweight (24 kg/m2 ≤ BMI <28.0 kg/m2) and obesity (≥28.0 kg/m2) increased the risk of ischaemic heart disease and ischaemic stroke. 28.0 kg/m2) increased the risk of ischaemic heart disease and ischaemic stroke.

Finally, there are psychological factors. It is common for patients with cardiovascular disease to have a combination of psychiatric problems, including poor mood, anxiety and depression, panic attacks and delirium, with anxiety and depression being the most common.

Professional studies have found that cardiovascular disease and psychosocial problems are mutually influential and causal. On the one hand, psychological problems are a risk factor for cardiovascular disease and an important factor in its treatment and prognosis, for example, depression is an independent risk factor for cardiovascular disease; On other hands, cardiovascular disease increases the risk of psychological disease, so the two tend to form a vicious circle. Therefore, a focus on mental health has an important role in the prevention of cardiovascular disease and an objective assessment of the psychological status of cardiovascular patients is also important for their treatment and prognosis.

The cardiovascular disease treatment market is promising with strong growth in the thrombolytic drug scale.

As we have seen, cardiovascular disease can be very aggressive these days. Because it can cause various adverse symptoms after the onset of the disease, if not detected early and treated appropriately, the continued existence of a variety of bad habits can overwhelm the heart and cause vascular lesions that can end up threatening life and health.

In line with the treatment approach followed for many diseases, the prevention and treatment of cardiovascular disease also advocate’ early detection and early treatment’, with the main treatment options currently including drugs, thrombolysis, open surgery and interventional therapy. Thrombolysis is becoming increasingly accessible and has become more common in recent years in the clinical treatment of cardiovascular disease, with the market is growing faster than other treatment paradigms.

Public information on the industry market shows that the current market for thrombolytic drugs accounts for about 11% of China’s antithrombotic drug market, and in recent years the market size in this area has been growing rapidly at a rate of about 30%. As one of the fastest-growing branches of the market in recent years, the application of thrombolytic drugs in the clinic tends to be normalized.

The commonly used thrombolytic drugs in the market today are urokinase (UK), streptokinase (SK), alteplase (rt-PA), Pro-UK, alteplase (r-PA) and tenecteplase (TNK-Tpa). At the same time, some emerging biotech companies are also starting to set up markets in the cardiovascular therapeutic area, especially in the thrombolytic therapy segment, and HKND is one of them.

As an innovative biopharmaceutical company, the biomolecule drug delivery vehicle YB1 developed by HKND uses the world’s first thrombus-targeting technology. It can combine with various thrombolytic drugs to precisely target the thrombus and release the thrombolytic drug, providing a precise and targeted thrombolytic effect.

At present, the company has developed and laid out three innovative thrombolytic drug product pipelines, and the core technology product YB1 can be combined with a variety of thrombolytic drugs to treat various thrombotic diseases. The three existing thrombolytic drug products under development are YB1-rt-PA, YB1-rt-DE and YB1-rt-PL. We are looking forward to more breakthroughs in the development of new drugs to help prevent and treat cardiovascular diseases.