Cardiovascular Health in Hong Kong: Why It Matters 

Cardiovascular disease (CVD) remains a significant health concern in Hong Kong, ranking as the third leading cause of death and accounting for approximately 12.6% of all registered deaths. Despite this, many individuals are unaware of their underlying risk factors. 

Findings from the Population Health Survey 2020–22 highlight a concerning gap in awareness: 

• 41% were unaware they had hypertension 
• 36.5% did not know they had diabetes 
• Nearly 70% did not realise they had elevated cholesterol levels 

These figures underscore the importance of early detection and regular health screening. Many cardiovascular risk factors develop silently, without obvious symptoms, making proactive monitoring essential for timely intervention.

Dyslipidemia is the primary driving force behind atherosclerosiscardiovascular disease (ASCVD) and cardiovascular disease (CVD), significantly increasing the risk of heart attacks and strokes. It is characterised by high LDL "bad" cholesterol, high triglycerides, or low HDL "good" cholesterol. Hypercholesterolemia is the most common form of dyslipidemia.  

Early intervention, including lifestyle optimisation and pharmacological treatment when indicated, is recommended for patients with dyslipidaemia, especially in younger individuals with familial hypercholesterolaemia (FH) or a strong family history of premature ASCVD.

Recent updates to international cholesterol guidelines reflect a growing emphasis on earlier prevention, personalised care, and clearer treatment goals. For patients, this means more precise guidance on how to manage cholesterol and reduce long-term cardiovascular risk. 

Lifestyle changes, such as improving diet, increasing physical activity, and stopping smoking, are the foundation of managing cardiovascular risk. When lifestyle changes alone are not sufficient, medication may be recommended. Treatment is typically approached in a stepwise and individualised manner:

• Statins as first-line treatment  

• Additional non-statin medications including ezetimibe and/or bempedoic acid or PCSK9 mAb, if statin monotherapy is insufficient 

This ensures that patients receive the right level of treatment, without unnecessary overtreatment. 

Statins continue to be the first-line and most widely studied treatment for lowering cholesterol and reducing cardiovascular risk.

They are recommended for many patients, including those aged 40-75 years with:

• Diabetes 
• Chronic kidney disease stage 3-4 
• HIV 

Extensive research has consistently shown that statins reduce the risk of heart attack, stroke, and cardiovascular death.

For most individuals, statins are well tolerated, and the benefits of treatment significantly outweigh the side effects and potential risks. 

One of the most important updates is the return of specific LDL cholesterol (“bad cholesterol”) targets, tailored to your individual risk level.

• For those at lower risk, the goal is less than 2.6 mmol/L 
• For higher-risk individuals, the target is below 1.8 mmol/L 
• For those with existing heart disease or very high risk, the goal is below 1.4 mmol/L 

This approach helps ensure that treatment is proportionate to your risk, with more intensive management for those who need it most. 

The latest guidance also places greater emphasis on younger adults and inherited conditions, such as familial hypercholesterolaemia.

Rather than waiting until later in life, the focus is on identifying risk early and intervening sooner, helping to prevent complications before they develop. 

Some patients are concerned about the link between statins and diabetes. While statins have been associated with a small increase in the risk of developing type 2 diabetes, this is generally seen in individuals who already have underlying risk factors like obesity, impaired fasting glucose and metabolic syndrome.

Importantly, for the majority of patients: 

• The reduction in cardiovascular risk far outweighs this small increase in diabetes risk, particularly for those with intermediate or higher ASCVD risk 

• Statins should not be withheld for this reason alone.  

Also, your doctor may recommend regular monitoring of blood sugar levels and support lifestyle measures such as maintaining a healthy diet, weight, and activity level.

Cardiovascular disease remains a leading health concern in Hong Kong, often driven by silent risk factors such as high cholesterol, hypertension, and diabetes. As many individuals are unaware of their condition, regular screening and early detection are essential. 

Dyslipidaemia is a key driver of heart disease but is highly manageable with lifestyle changes and appropriate treatment. The latest cholesterol guidelines highlight several important updates patients should know: 

• Statins remain the first-line treatment 
• Clear LDL cholesterol targets based on individual risk 
• Stepwise addition of therapies if needed 
• Earlier prevention, including for younger adults and inherited conditions 
• Balanced guidance on statins and diabetes risk
• Greater focus on personalised risk assessment

Taking a proactive approach can help you reduce cardiovascular risk and protect your long-term heart health.  

1. Centre for Health Protection. (2025). 'Non-communicable diseases watch: cardiovascular diseases.' Centre for Health Protection, Department of Health, Hong Kong. Available at: https://www.chp.gov.hk/files/pdf/ncd_watch_sep_2025_en.pdf [Accessed: 23 June 2026]. 
2. Du, Z. and Qin, Y. (2023). 'Dyslipidemia and cardiovascular disease: current knowledge, existing challenges, and new opportunities for management strategies.' Journal of Clinical Medicine, 12(1), p. 363. Available at: https://doi.org/10.3390/jcm12010363. 
3. Blumenthal, R.S., Morris, P.B. et al. (2026). '2026 ACC/AHA/AACVPR/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the management of dyslipidemia: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines.' Circulation, 153, pp. e1154 to e1276. Available at: https://doi.org/10.1161/CIR.0000000000001423.