25，000) showing that calcification is both more prevalent and more extensive in northern than in southern Chinese cities and that traditional risk factors do not explain these differences (7).  This study needs to be followed with similar studies in the Chinese countryside and in other parts of China.

American cardiovascular epidemiologists commonly use these kinds of non invasive cardiovascular imaging for the study of vascular epidemiology (8-10).  US studies with sample sizes of only a few thousand， such as the Coronary Artery Risk Development in Young Adults study (8)， the Multi-ethnic Study of Atherosclerosis  (9)and the Cardiovascular Health Study (10) have used echo-cardiography， carotid artery ultrasound and computed tomography for coronary calcification.    Interest in these modalities has increased as it has become clear that non invasive imaging markers of atherosclerosis， like carotid intimal thickness， left ventricular mass and coronary artery calcium score are strongly linked to cardiac events.  Such a link between easily obtainable imaging information and disease prevalence and future incidence， enhances the epidemiologists’ ability to determine new risk factor correlations while it greatly reduces the cost of elucidating this information.

The emergence of imaging technologies in China and the pressing need to limit costs of cardiovascular imaging research makes this methodology ideal for application to Chinese epidemiology. 

References

1. Sun Z， Zheng L， Detrano R， Zhang D，Zhang X， Xu C， Li J， Liu S， Li J， Hu D， Sun Y.
The Accelerating Epidemic of Hypertension among Rural Chinese Women: Results from Liaoning Province， Am J Hypertension (in press).
2. Wu X， Huang Z， Stamler J， Wu Y， Li Y， Folsom AR， Tao S， Rao X， Zhang H， Cen R， Wang S， Shen L， Liu S， Chen H， Yu X， Tian X， Huang M， He Y. Changes in average blood pressure and incidence of high blood pressure 1983-1984 to 1987-1988 in four population cohorts in the People’s Republic of China. The PRC-USA Cardiovascular and Cardiopulmonary Epidemiology Research Group. J Hypertens. 1996; 14 (11): 1267-74.
3. Sun Z.， Zheng L.， Wei Y.， Li J， Zhang X.， Zhang X.， Liu S.， Xu C.， Li J.， Zhao F.， Dong G.， ，Hu D，， Sun Y.. The Prevalence of Prehypertension and Hypertension among Rural Adults in Liaoning Province of China. Clin. Cardiol. 2007; 30: 183–187.
4. Detrano R， Wu Y， Li Y， Azen S， Wong ND， Gardin J.  Left ventricular mass in untreated hypertensives in Yunnan Province. (in progress)
5. Zhao D. “The epidemiology of coronary heart disease in 16 provinces of China (MONICA Project)”. Zhong Hua Liu Xing Bing Xue Za Zhi. 1993;14:10-13 
6. Zhou BF et al. CVD Prevention.1998;1:207-216
7. Detrano R，  Wu Y， Zhao L，， Ding D， Liu XQ，  Lu B， Meng HJ， Li X， Zhuang N， Dustin L， Azen S.  Sub-clinical Coronary Heart Disease in Northern and Southern China: The Chinese Paradox.   (in review). 
8. Lorber R?， Gidding SS， Daviglus ML， Colangelo LA， Liu K， Gardin JM，  Influence of systolic blood pressure and body mass index on left ventricular structure in healthy African-American and white young adults: the CARDIA study.  Journal of the American College of Cardiology Volume 41， Issue 6， 19 March 2003， Pages 955-960. 
9. Detrano R，  Guerci AD， Carr JJ， Bild DE， Burke B， Folsom A， Liu K， Shea S， Szklo， M， Bluemke D，  O’Leary， D.， Tracy R， Watson K， Wong ND，  Kronmal RA.  Coronary Calcium as a Predictor of Coronary Events in Four Ethnic Groups，  NEJM 358;13 March， 2008.
10. Gardin J， Siscovick D， Anton- Culver H， Lynch J et al.  Sex， Age， and Disease Affect Echocardiographic Left Ventricular Mass and Systolic Function in the Free-Living Elderly The Cardiovascular Health Study. Circulation. 1995;91:1739-1748.

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