Chronic conditions are important problems for an aging society. They impede on healthy aging and increases the cost of living due to increased medical cost. The most prevalent chronic conditions faced by the elderly population are hypertension, high cholesterol and diabetes mellitus. They increase the risk of developing atherosclerosis, a chronic condition which causes heart attack and stroke. This chapter provides a review on existing therapeutics for the treatment of cardiovascular disease, and briefly discusses their side effects. This chapter also provides a brief introduction to Traditional Chinese Medicine (TCM), and its development in ancient China. This will be followed by a discussion on the recent research on the use of Chinese herbal medicine (CHM) in the treatment of cardiovascular diseases, and the potentials and challenges of incorporating CHM in mainstream healthcare system.
TopBackground
There has been an increasing life expectancy in the populations of most developed countries in the last decade. From 2004 to 2014, life expectancy for both male and female increased by 2 years in most countries including Hong Kong (Food and Health Bureau, 2016). Moreover, in Hong Kong approximately 15% of the population are aged 65 years or older at the end of 2015 (Census and Statistics Department Hong Kong SAR, 2016). It is expected to double and reach approximately 30% in the next 20 years (Census and Statistics Department Hong Kong SAR, 2015), and by then the median age will shift to 50. The increase in life expectancy and the aging of population over the past decades have led to a substantial increase in age-related cardiac, arterial and microvascular diseases in developed countries. It is well documented that aging is closely associated with the progressive decline in normal physiological functions and has significant impact on the heart and vascular system. The incidence of ischemic heart disease and stroke increases exponentially with aging.
According to the World Health Organization (WHO) (2014), ischemic heart disease and stroke were the top two leading causes of death in 2012, accounting for 7.4 million and 6.7 million of deaths, respectively. In Hong Kong, diseases of heart and cerebrovascular diseases were both listed among the top four causes of death in Hong Kong for elderly people aged 65 and over (Census and Statistics Department Hong Kong SAR, 2014).
In a recent study in Hong Kong, total direct medical cost for a patient newly diagnosed with stable ischemic heart disease is approximately HK$ 89,700 (US$ 11,500) in the first-year, where the cost can be significantly higher if the patients required surgical procedures for their conditions (Lee et al., 2013). These costs are currently not being covered under the Public healthcare in Hong Kong, and the patients are often required to pay out of pocket. The ongoing cost in managing chronic conditions is also likely to increase, due to an extended lifespan of individuals and inflation. In the coming years, the society will be facing an increase in the proportion of elderly people and the decrease in the number of working population. Moreover, the public healthcare sectors face shortage of doctors and the lack of hospital beds in public hospitals. Therefore, there is a pressing need to develop more effective medications to combat aging-related cardiovascular diseases, as well as effective ways to prevent cardiovascular complications once chronic conditions, such as diabetes and high cholesterol level, are detected.