Rapid urbanization and a shift in lifestyles are the key factors behind a 20-year increase in heart disease among Chinese, according to a Harvard University study.[Photo/Xinhua]

Rapid urbanization and a shift in lifestyles are the key factors behind a 20-year increase in heart disease among Chinese, according to a Harvard University study.

The study by the Harvard T.H. Chan School of Public Health suggests that major changes in Chinese society may have contributed to the surge in cardiovascular diseases, which can lead to heart attacks and stroke.

Also found were increases in high-cholesterol cases, obesity and Type 2 diabetes.

The study, published on Monday in the Journal of the American College of Cardiology, contends that an increasing body mass index, lower physical activity, smoking and unhealthy diets have contributed to the rise in cardiovascular disease, the No 1 cause of death in China.

Tobacco use is falling in China, but 53.4 percent of the nation's men still smoke. In 2011, tobacco use was connected to 1.3 million cases of cardiovascular disease, the study found.

Low-grade cigarettes can be had for 3 yuan (49 cents) a pack in China, the world's largest cigarette market. China has 300 million smokers; the US has an estimated 60 million.

In 2015, Beijing city authorities passed anti-smoking legislation banning smoking in all indoor public places, workplaces and on public transportation.

The study's authors also noted that while the Chinese diet has improved in some areas - with more fiber, fruit, nuts and omega-3 fatty acids - the consumption of red meat and sugary beverages is growing.