Hong Kong’s Push on World Heart Day: Prevention, Primary Care and Practical Steps to Cut Cardiovascular Risk

Table of Contents

1. Key Highlights
2. Introduction
3. Why cardiovascular disease still claims so many lives in Hong Kong
4. How everyday habits translate into cardiovascular risk
5. Salt, cholesterol and blood sugar: the numbers that clinicians and individuals should watch
6. The Co-care Network and CDCC Scheme: restructuring prevention around primary care
7. The Action Plan on Weight Management and the 10,000 Steps initiative: translating advice into habits
8. Sedentary behaviour: small interruptions with outsized benefits
9. Screening: what to expect and what numbers mean for you
10. Practical daily plan: how a resident can cut cardiovascular risk in 12 months
11. Community and policy measures that shift population risk
12. Equity considerations: make prevention reachable for all
13. Measuring success: health outcomes and economic value
14. What clinicians and family doctors should prioritise
15. The role of technology and social support in sustaining change
16. International comparisons and lessons learned
17. Common barriers and how to overcome them
18. How families can create a heart-healthy home
19. The next five years: what to watch
20. FAQ

Key Highlights

• Hong Kong’s Department of Health urges lifestyle changes—balanced diet, regular activity, quitting smoking and avoiding alcohol—and promotes new preventive programmes including the Co-care Network and the 10,000 Steps challenge.
• Local data show substantial gaps: high average salt intake (8.4 g/day), widespread overweight/obesity, prolonged sedentary time, and notable prevalence of raised blood pressure (30%) and high cholesterol (52.7%); early results from the Chronic Disease Co-Care Scheme demonstrate measurable clinical improvements.

Introduction

Cardiovascular disease remains the top cause of death worldwide. On World Heart Day, Hong Kong’s Department of Health reinforced that preventing heart attacks and strokes depends largely on everyday choices and on systems that make healthy choices easier. The Government’s recent initiatives—the Co-care Network, an Action Plan on Weight Management and a public-facing 10,000 Steps challenge—seek to combine community outreach, primary-care partnerships and individual behaviour change. Local surveys and preliminary programme evaluations reveal both the size of the challenge and the potential for improvement when prevention is structured, accessible and sustained.

This report synthesises the latest Hong Kong data, explains the mechanisms linking lifestyle to heart risk, describes the key features of the Co-care Network including the Chronic Disease Co-Care Scheme (CDCC), and offers concrete, evidence-based steps individuals and communities can take to reduce cardiovascular risk.

Why cardiovascular disease still claims so many lives in Hong Kong

Global estimates from the World Health Organization put cardiovascular diseases (CVDs) at roughly 17.9 million deaths per year. Hong Kong’s provisional figures for 2025 attribute 10,119 registered deaths to CVDs—about 19.6% of all deaths—with heart disease responsible for approximately two-thirds of those cases. These numbers persist despite medical advances because most heart attacks and strokes arise from preventable risk factors that accumulate over decades.

Population-level risk in Hong Kong clusters around several measurable problems:

• Excess dietary salt and calorie intake, fueling raised blood pressure and obesity.
• Prolonged sedentary behaviour and insufficient moderate-to-vigorous physical activity.
• Suboptimal control of metabolic risk factors such as high cholesterol, elevated blood glucose and hypertension.
• Continued tobacco use and alcohol consumption among subgroups.

Those risk patterns explain why prevention matters more than ever. Clinical care can treat acute events and control established disease, but preventing the upstream causes reduces both mortality and long-term healthcare costs.

How everyday habits translate into cardiovascular risk

Cardiovascular risk reflects the combined effect of behaviours, biology and environment. Clear causal pathways exist between common lifestyle exposures and the “three highs” targeted by Hong Kong’s prevention programmes: high blood pressure, high blood sugar and high cholesterol.

Diet and salt High dietary sodium raises blood pressure by altering fluid balance and vascular tone. The Department of Health’s Population Health Survey 2020–22 found the average adult in Hong Kong consumes 8.4 grams of salt daily—well above the World Health Organization’s recommendation of less than 5 g/day. Persistent excess sodium increases the probability of stroke and coronary heart disease through sustained elevation of systolic and diastolic blood pressure.

Calories, fats and sugar Energy imbalance leads to overweight and obesity. Excess adiposity worsens insulin resistance, increases blood pressure and alters lipid profiles—raising triglycerides and lowering HDL cholesterol. Over half of Hong Kong’s adult population is overweight or obese; that prevalence magnifies the population burden of CVD.

Tobacco and alcohol Cigarette smoking accelerates atherosclerosis, increases thrombosis risk and impairs endothelial function—mechanisms that raise the likelihood of heart attack and stroke. Alcohol has a dose-dependent relationship with cardiovascular risk: light-to-moderate consumption may have mixed associations, but heavier drinking increases blood pressure, promotes arrhythmias and aggravates cardiomyopathy.

Physical activity and sedentary behaviour The WHO recommends 150–300 minutes of moderate-intensity or 75–150 minutes of vigorous-intensity aerobic activity weekly, or an equivalent mix. Hong Kong’s Health Behaviour Survey 2023 found 14.8% of adults do not meet these aerobic activity targets. Meanwhile, 33.9% of adults sit or recline for more than eight hours daily, aside from sleep. Extended sedentary time independently increases cardiovascular risk, even among people who exercise; frequent short breaks—standing, short walks, light calisthenics—reduce metabolic stress and hemodynamic stagnation linked to vascular disease.

Salt, cholesterol and blood sugar: the numbers that clinicians and individuals should watch

Screening and risk stratification make prevention actionable. Several markers provide concrete targets for both clinicians and people trying to reduce risk.

Blood pressure Raised blood pressure affects roughly 30% of adults in Hong Kong. Hypertension is commonly defined as a sustained systolic blood pressure (SBP) ≥140 mmHg or diastolic ≥90 mmHg in many clinical settings, though guideline targets for treated patients and management thresholds vary by organisation and individual risk. The early results from Hong Kong’s CDCC Scheme noted an average reduction in SBP from 150 mmHg to 135 mmHg after 12 months among hypertensive participants—an improvement associated with substantially lower cardiovascular event risk.

Glycaemic control Raised blood glucose (including diabetes and prediabetes) affects 8.6% of Hong Kong adults per the Population Health Survey. Glycated haemoglobin (HbA1c) gives a medium-term picture of glucose control; values of 6.5% or greater typically define diabetes, while 5.7–6.4% indicate prediabetes. In the CDCC evaluation, average HbA1c among participants with diabetes improved from 7.8% to 6.7% after a year, moving many toward recommended control ranges.

Cholesterol Elevated total cholesterol occurs in more than half of adults (52.7%). Management uses LDL cholesterol as the main target, with specific goals set by absolute cardiovascular risk. Lifestyle changes—reduced saturated fat intake, weight loss, and increased physical activity—lower LDL and triglycerides. Pharmacologic therapy, principally statins, remains effective for primary and secondary prevention in those at high risk.

Body mass index and waist circumference BMI remains a widely used measure for overweight and obesity; however, central obesity measured by waist circumference better predicts metabolic risk in many Asian populations. The CDCC participants with prediabetes experienced an average BMI reduction of 0.52 kg/m² after 12 months, a modest but meaningful change at the population level.

The Co-care Network and CDCC Scheme: restructuring prevention around primary care

March 2026 marked a significant shift in Hong Kong’s approach to cardiovascular prevention with the launch of the Primary Healthcare Co-care Network. Guided by “whole-person health,” the Network integrates evidence-based preventive services across the life course and creates pathways between community, primary care and specialised services.

Key features of the Co-care Network

• Life-course preventive measures that address risks at different ages and stages.
• Structured frameworks for regular screening and proactive management of high-risk conditions.
• Public-private collaboration: the CDCC Scheme subsidises services delivered in the private primary-care sector to increase access.

How the Chronic Disease Co-Care Scheme works The CDCC Scheme targets Hong Kong residents aged 45 or above who do not have a known diagnosis of diabetes mellitus or hypertension. Participants select a family doctor and receive comprehensive CVD risk-factor screening and management on a co-payment basis. The scheme emphasises early prevention, early detection and early treatment, with systematic follow-up and targeted interventions for identified risk factors.

Why primary care matters Primary care offers continuity and relationship-based care, which improves adherence, enables risk factor monitoring and anchors lifestyle counselling. By funding proactive screening and linking patients to a trusted family doctor, the CDCC reduces barriers to early detection and fosters longitudinal management—essential elements for controlling chronic disease at scale.

Early evidence of impact Preliminary analysis conducted by a local university team indicates clinically meaningful improvements among CDCC participants:

• Average systolic blood pressure in hypertensive patients decreased from 150 to 135 mmHg after 12 months.
• Average HbA1c in patients with diabetes declined from 7.8% to 6.7% over the same timeframe.
• Average BMI among participants with prediabetes fell by 0.52 kg/m².

These changes reflect both behavioural shifts and likely better pharmacologic optimisation where appropriate. When scaled, such improvements translate into fewer heart attacks, strokes and long-term healthcare costs.

The Action Plan on Weight Management and the 10,000 Steps initiative: translating advice into habits

The Department of Health’s Action Plan on Weight Management (announced March 2026) and the 10,000 Steps a Day Walking Challenge aim to make daily physical activity achievable and measurable for the public.

Why 10,000 steps? The 10,000 steps goal is a simple, familiar benchmark that promotes habitual activity. While not a one-size-fits-all prescription, it encourages incremental increases in daily movement—walking to transit, taking stairs, short walks during breaks—that add up to meaningful calorie expenditure and cardiovascular benefit. The e+Life platform within the eHealth app hosts the challenge, offering route suggestions and social features to encourage sustained participation.

Practical strategies embedded in the Action Plan on Weight Management

• Awareness campaigns to shift norms around portion sizes and beverage choices.
• Collaborations with workplaces and communities to provide weight-management resources.
• Tools for personalised goal-setting and tracking, including the 10,000 Steps challenge and thematic walking routes for families.

Real-world examples

• A midtown office introduces mandatory 10-minute walking breaks twice daily and provides standing desks; employees report more energy and reduced mid-afternoon slumps.
• A neighbourhood group uses the e+Life thematic walking routes to organise weekend family walks, integrating social incentives that increase adherence over time.

Behavioural science supports small, repeated changes: shifting a daily commute to include a 15-minute brisk walk, choosing smaller portions, or replacing a sugary beverage with water will produce measurable benefits when maintained.

Sedentary behaviour: small interruptions with outsized benefits

Sedentary time operates through pathways distinct from the benefits of exercise. Prolonged sitting reduces muscle activity, impairs glucose metabolism, and increases vascular inflammation. Breaking up sitting time with brief activity lowers postprandial glucose and insulin responses and improves endothelial function.

Practical, evidence-informed interruption strategies

• Set a timer to stand or walk for two to five minutes every 30–60 minutes.
• Use standing or walking meetings when feasible.
• Replace one seated TV episode with a 20-minute walk.
• During long commutes, stand on public transit and add short walks at transfer points.

Even light-intensity activity counts when it replaces long periods of sitting. Employers and public spaces can support these behaviours by providing safe walking routes, accessible stairwells and flexible schedules.

Screening: what to expect and what numbers mean for you

Early detection depends on clear, routine screening. The CDCC Scheme and life-course preventive services emphasise regular checks tailored by age and risk.

Core screening components

• Blood pressure measurement: annual or more frequent checks for those with elevated readings.
• Blood tests for fasting glucose/HbA1c and full lipid profile.
• Body mass index, waist circumference and lifestyle risk assessment (smoking, alcohol, diet, activity).
• Cardiovascular risk calculation using validated tools that combine age, sex, blood pressure, cholesterol and smoking status.

Interpreting common results

• Blood pressure: sustained SBP ≥140 mmHg typically indicates hypertension; treatment targets vary by age and comorbidities but reducing SBP by 10–20 mmHg yields significant reduction in stroke and myocardial infarction risk.
• HbA1c: values ≥6.5% indicate diabetes; many guidelines set individualized targets (for example, <7.0% for many adults), balanced against hypoglycaemia risk and comorbidity.
• LDL cholesterol: target levels depend on absolute risk; high-risk individuals often require LDL reductions to well below previous population norms.

Follow-up actions Screening is the start. Elevated measures should prompt personalised plans that combine lifestyle interventions, close monitoring and medications when indicated. Regular reassessment at intervals determined by initial risk ensures timely intensification or de-escalation of therapy.

Practical daily plan: how a resident can cut cardiovascular risk in 12 months

Small, structured changes produce measurable results if maintained. The example below outlines a practical 12-month roadmap that aligns with Hong Kong’s programmes and evidence-based targets.

Months 1–2: Baseline and commitment

• Register for the CDCC Scheme or arrange a primary-care checkup. Obtain baseline measures for BP, HbA1c, lipids, BMI and waist circumference.
• Set specific, measurable goals: for example, reduce daily salt intake to <6 g in 2 months; walk 7,000 steps/day initially and increase toward 10,000.

Months 3–6: Habit formation and incremental improvements

• Incorporate daily structured activity: brisk 30-minute walk five days a week or equivalent; use e+Life walking routes for variety.
• Reduce sugar-sweetened beverages and preferentially choose whole foods; aim for at least five servings of fruit and vegetables daily.
• Introduce two to three short breaks from sitting during the workday.
• If screening identifies elevated BP, lipids or glucose, work with the family doctor on a combination of lifestyle measures and possible medication.

Months 7–12: Consolidation and reassessment

• Re-screen key markers at 6–12 months. Expect measurable changes: modest weight loss (5% body weight), reductions in SBP, and improved HbA1c among those with elevated glucose.
• Join local peer groups or community-based programmes to sustain physical activity and dietary compliance.

Expected clinical improvements The CDCC evaluation demonstrates achievable targets: a 15 mmHg reduction in systolic BP, an approximate 1.1% reduction in HbA1c for those with elevated glucose and measurable BMI decreases. These translate into lower short-term risk and meaningful lifetime gains.

Community and policy measures that shift population risk

Individual behaviour change matters, but the environment determines how easy those changes are to make. Hong Kong’s approach combines policy levers, community delivery and healthcare system reform.

Built environment and active living Designing streets and public spaces that prioritise pedestrian safety and comfort increases incidental activity. Safe walking routes, well-lit parks and connected greenways encourage everyday movement.

Food environment interventions Policies that reduce sodium in processed foods, mandate front-of-pack labelling, and limit marketing of unhealthy food to children change consumption patterns. Public campaigns that make healthy choices easier—like smaller default portions and healthier vending options—produce measurable reductions in calorie and sodium intake.

Workplace health programmes Employers that promote flexible breaks, standing desks, workplace exercise classes and healthy cafeteria options create opportunities to reduce sedentary time and improve diet among a large adult population.

Primary care incentives and data systems Subsidies and co-pay models, such as the CDCC Scheme, lower financial barriers to preventive care. Integrating screening data across primary-care networks allows targeted outreach to high-risk groups and better monitoring of population-level outcomes.

Equity considerations: make prevention reachable for all

Population impact requires equitable access. Low-income groups, older adults and those with limited English or Chinese literacy often face higher barriers to healthy food, safe activity spaces and primary-care access.

Strategies to close equity gaps

• Tailor outreach and materials in multiple languages and literacy levels.
• Subsidise preventive services for vulnerable groups, not just the general population.
• Locate District Health Centres and community outreach where need is greatest.
• Partner with NGOs and community leaders to deliver culturally relevant programmes.

Equity-minded prevention not only reduces individual harm but prevents widening health disparities as chronic conditions grow more prevalent.

Measuring success: health outcomes and economic value

Reduction in CVD incidence and mortality constitutes the ultimate measure. Intermediate indicators include improved blood pressure control, lower average LDL cholesterol, reduced HbA1c and decreased population BMI.

Economic returns Preventing heart attacks and strokes saves costs from hospitalisations, rehabilitation and long-term care. Early cost-effectiveness assessments of programmes like CDCC suggest improved health outcomes with favourable cost profiles, driven by fewer acute events and better chronic disease management.

Scaling and sustaining results Sustained funding, continuous quality improvement and robust data collection are essential. Real-world implementation science will determine how Hong Kong’s pilot improvements translate to long-term population-level declines in CVD burden.

What clinicians and family doctors should prioritise

Primary-care clinicians play a central role in prevention. Priorities include:

• Regular screening of adults aged 45 and above, with earlier checks for individuals with family history or elevated risk.
• Effective brief counselling on diet, physical activity, smoking cessation and alcohol moderation.
• Use of absolute cardiovascular risk calculators to guide pharmacologic therapy.
• Coordination with allied health professionals—dietitians, physiotherapists, smoking-cessation counsellors—to offer comprehensive care.
• Active follow-up systems to ensure adherence and timely intensification when targets are unmet.

Family doctors who leverage the Co-care Network can provide continuity and holistic care, increasing the probability that preventive interventions succeed.

The role of technology and social support in sustaining change

Digital tools can enhance adherence by making goals visible and social. Examples:

• Pedometer and smartphone apps that track steps, log food and provide reminders.
• Telehealth check-ins for monitoring blood pressure and medication adherence.
• Social groups and community challenges through platforms like e+Life to provide peer support.

Technology is not a replacement for human contact, but it removes friction and allows scalable, low-cost support structures.

International comparisons and lessons learned

Countries that focused on salt reduction, tobacco control and primary-care screening have seen rapid public health gains. Finland’s salt-reduction campaigns and the United Kingdom’s excise and labelling policies for tobacco and unhealthy food are instructive. The central lesson: combining regulation, community programmes and primary-care integration yields faster, more durable improvements than any single intervention.

Hong Kong’s Co-care Network mirrors successful elements from these examples: structured primary-care screening, public engagement campaigns and accessible tools for daily activity.

Common barriers and how to overcome them

Barrier: Time constraints for working adults

• Solution: Short, frequent activity bouts; walking meetings; use of stairways.

Barrier: Taste preferences and cultural diet patterns that favour salty or high-fat foods

• Solution: Gradual salt reduction, flavour substitutes (herbs, citrus), cooking demonstrations that adapt traditional recipes to be lower in salt and fat.

Barrier: Cost of healthier food

• Solution: Highlight affordable, heart-healthy staples—legumes, seasonal vegetables, whole grains—and provide community cooking classes that emphasize budget-friendly choices.

Barrier: Limited access to primary care or distrust of medical system

• Solution: Community outreach through District Health Centres, trusted local leaders and subsidised preventive packages under schemes like CDCC.

How families can create a heart-healthy home

• Make fruits and vegetables the default snacks; place them within reach.
• Reduce availability of sugary drinks and processed salty snacks at home.
• Schedule family walks after dinner to replace sedentary screen time.
• Encourage smoke-free homes and model moderate or no alcohol consumption.

Small household norms compound over years, shifting risk trajectories for all family members.

The next five years: what to watch

• Programme scaling: Will the Co-care Network reach coverage sufficient to affect population-level CVD incidence?
• Data transparency: Regular publication of outcome metrics (BP control rates, mean population LDL, salt intake trends) will be critical to monitor progress.
• Policy reinforcement: Measures that reduce sodium in the food supply and strengthen tobacco control will amplify individual-level interventions.
• Equity outcomes: Observing reductions in disparities across income and age groups will indicate the true public health impact.

Early CDCC results are promising, but sustained investment and system-level alignment will determine whether Hong Kong achieves measurable declines in heart disease and stroke.

FAQ

Q: What immediate steps should I take to reduce my heart disease risk? A: Start with a primary-care screening for blood pressure, glucose and cholesterol. Commit to daily movement—working toward 150 minutes of moderate aerobic activity weekly or 10,000 steps a day as an accessible benchmark—reduce daily salt to nearer 5 g, increase fruit and vegetable intake to at least five servings daily, stop smoking, and limit alcohol. Use the Co-care Network or CDCC Scheme if eligible for structured screening and follow-up.

Q: Who is eligible for the Chronic Disease Co-Care Scheme and how does it work? A: Hong Kong residents aged 45 or above without known diabetes or hypertension are eligible. Participants select a family doctor and receive subsidised screening and management for cardiovascular risk factors in the private primary-care sector on a co-payment basis. The scheme emphasizes early detection and longitudinal management.

Q: How much difference can small changes make—will a modest weight loss or step increase really help? A: Yes. Even modest weight loss (5–10% of body weight) improves blood pressure, glucose regulation and lipid profiles. Increasing daily steps and reducing sedentary time lowers cardiometabolic markers. The CDCC reported average improvements such as a 15 mmHg reduction in systolic BP and a 1.1% reduction in HbA1c among participants, demonstrating that structured interventions yield measurable gains.

Q: Is sodium reduction realistic given local food preferences? A: Gradual sodium reduction is realistic and effective. Industry reformulation, reduced use of high-sodium condiments, cooking with herbs and citrus for flavor, and choosing lower-salt packaged products all help. Public education and policy measures that reduce sodium in commercially prepared foods will support individual efforts.

Q: Does standing up occasionally offset a sedentary lifestyle if I still don’t exercise? A: Brief, frequent breaks from sitting reduce some risks associated with prolonged sedentary time, improving post-meal glucose and vascular function. However, regular moderate-to-vigorous activity provides additional benefits and should be combined with reduced sitting for maximal effect.

Q: Where can I find reliable resources and programmes mentioned by the Department of Health? A: The Department of Health’s Change for Health portal and the e+Life platform of the eHealth mobile app host resources, the 10,000 Steps a Day Walking Challenge and information about the Co-care Network and CDCC Scheme. District Health Centres also provide life-course preventive care services.

Q: What role do medications play alongside lifestyle change? A: Medications—including antihypertensives, statins and glucose-lowering drugs—remain essential for individuals at elevated risk or with established disease. The best outcomes come from combining lifestyle interventions with appropriate medication when indicated. Primary-care providers guide individualized decisions using absolute risk assessment and patient preferences.

Q: How will the Government measure whether these prevention initiatives are working? A: Measures include changes in population-level indicators (mean blood pressure, mean cholesterol, average salt intake, physical activity prevalence, obesity rates) and clinical outcomes (incidence of myocardial infarction and stroke). Programme-specific metrics—screening uptake, adherence rates and intermediate clinical improvements—will inform ongoing adjustments.

Q: What if I can’t afford private primary care? A: The Co-care Network and CDCC Scheme aim to reduce cost barriers through subsidies and co-payment structures. District Health Centres and community clinics also provide preventive services. Community organisations and NGOs may offer low-cost programmes and education.

Q: How can employers support heart health for their staff? A: Employers can institute regular movement breaks, provide standing desks, encourage walking meetings, offer healthy food choices in cafeterias, and subsidise health checks. Workplace wellness programmes that incorporate social incentives and flexible schedules improve participation and health outcomes.

The path to lower cardiovascular disease in Hong Kong hinges on combining individual action with system-level solutions: accessible primary care, food and built-environment changes, and normalising daily physical activity. The Co-care Network, the Action Plan on Weight Management and the 10,000 Steps challenge provide concrete mechanisms for change. For individuals, the message is straightforward: regular screening, measured activity, a lower-salt balanced diet, and avoiding tobacco and excess alcohol substantially reduce the risk of heart attack and stroke.