How serious is heart disease in Hong Kong? The Centre for Health Protection's death figures, the official warning signs, and what happens at the Accident & Emergency Department

Last updated: 2026-09-13

Emergency note: The Department of Health's Elderly Health Service lists the signs of acute myocardial infarction — sudden onset of severe chest pain that may radiate to the neck, arm or jaw, profuse sweating, shortness of breath, nausea and vomiting or even passing out — and then instructs the reader to seek medical treatment immediately or attend an Accident & Emergency Department. The Fire Services Department gives the emergency ambulance number as 999. A list of symptoms is not a test for ruling a heart attack out by yourself.

The Centre for Health Protection of the Department of Health, in "Number of registered deaths by leading cause of death, 2001 - 2025", records 6,593 registered deaths from diseases of heart in 2025 (provisional figures), ranking third in that table when ordered by the 2025 figures, behind malignant neoplasms (15,368) and pneumonia (11,260). The same Centre's Heart Diseases health topic page (the page itself prints 31 March 2026) states, for 2024, that heart diseases accounted for 12.6% of all registered deaths, and that coronary heart disease made up 52.9% of heart disease deaths. The Population Health Survey 2020-22 found that 1.6% of persons aged 15 or above reported doctor-diagnosed coronary heart disease (males 2.1%, females 1.2%). ⚠️ The biggest misreading: looking only at the crude death rate for heart diseases (registered deaths per 100 000 mid-year population), which rose from 70.0 in 2001 to 87.9 in 2025, you would conclude that heart disease is becoming more lethal; but the same Centre's age-standardised death rate (registered deaths per 100 000 standard population) fell from 52.3 to 30.1 over the same period. The Centre itself prints this on the age-standardised table: "Since death rates for most diseases are strongly age-dependent and typically increase with age, direct comparisons of crude death rates over time can be highly misleading if the underlying age structure of the population has changed."

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#What are heart diseases, and what is coronary heart disease?

"Heart disease" is not one disease but a broad group; coronary heart disease is the part of it that accounts for the largest share of the deaths. The introduction to the Centre for Health Protection's Heart Diseases health topic page (the page itself prints 31 March 2026) reads:

"Heart Diseases" refers to a broad spectrum of diseases related to the heart. Among different types of heart diseases, coronary heart disease constitutes a major portion of the mortality. The disease occurs when cholesterol layers deposit on the inner wall of coronary arteries and narrow the lumens of the arteries. The process reduces blood supply to cardiac muscle and causes exertional chest pain known as angina.

Where does the name come from? The Hospital Authority's SmartPatient page on coronary heart disease (the page carries no self-printed date; the acknowledgement to the doctor who reviewed the content, which the Traditional Chinese version of the page prints, does not appear on the English page) states:

Coronary arteries are a system of blood vessels that supply heart muscles with oxygen and nutrients to keep the heart functioning. It is so called because the system of arteries is in the shape of a corona.
If, for any reason, the coronary arteries become narrowed or blocked, blood flow to the heart will diminish and the supply of oxygen to the heart muscles will decrease or stop. The patient will have chest pain and in the severe case a heart attack.

Which codes does the statistical category "heart diseases" contain? The Centre for Health Protection's mortality tables print the disease codes on each row, and the heart row reads "Diseases of heart (ICD-10: I00-I09, I11, I13, I20-I51)". The same Centre's health topic page, under "Situation in Hong Kong", separately states: "Heart diseases correspond to codes 390-429 in ICD-9 and I00-I09, I11, I13, I20-I51 in ICD-10. Coronary heart disease corresponds to codes 410-414 in ICD-9 and I20-I25 in ICD-10." — This site's reading is that heart diseases and coronary heart disease each have their own set of codes in the official statistics, and that coronary heart disease is a part of heart diseases.

⚠️ The statistical system changed. The Centre for Health Protection prints the following paragraph above that table: "Since 2001, the classification of diseases and causes of death has been based on the International Statistical Classification of Diseases and Related Health Problems (ICD), 10th Revision. The disease groups used for ranking causes of death have also been redefined according to the ICD-10, with new categories added. As a result, figures from 2001 onwards may not be directly comparable with those for earlier years, which were compiled using the ICD-9. Therefore, figures prior to 2001 are presented in a separate table." Every death figure in this article comes from that series beginning in 2001.

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#How does narrowing of the coronary arteries relate to acute thrombosis?

A coronary artery can narrow gradually, and a plaque can also rupture and trigger a thrombosis. The official material below describes the common mechanism. It cannot be used to decide for yourself, on the basis of "half blocked" or "fully blocked", whether you are having angina or a myocardial infarction.

First, the narrowing. The Hospital Authority's SmartPatient page on coronary heart disease:

When the fatty substance (made up of "lipoprotein" (the product of protein and lipid), cholesterol and other cellular waste products) in blood deposits on the inner wall of an artery, this is called atherosclerosis (hardening of the artery). It will lead to narrowing or even blockage of the blood vessel. Blood flow is thus interrupted, making the heart muscles unable to get sufficient oxygen and nutrients which results in shortage of oxygen in the heart muscles and even necrosis (death due to decay). The heart may stop beating and cause death.

Second, the rupture. The Hospital Authority Central Committee on Cardiac Service patient information leaflet Acute Myocardial Infarction (document no. PILIC0329E version 2.0, effective date 6 January 2020, last review date 15 March 2024) adds that step:

AMI is usually caused by atherosclerosis and thrombosis of coronary arteries. Heart is an important organ which pumps blood to various tissues in our body. Coronary arteries are blood vessels which supply blood, oxygen and nutrients for heart muscles to work. With time, particles like cholesterols and lipoproteins deposit on the wall of coronary arteries and form plaques. The process is known as atherosclerosis which continues and causes progressive narrowing of blood vessels. The plaque can sometimes rupture which attracts platelets and fibrin leading to thrombosis and blockages. Without blood supply, heart muscles cannot function and begin to die.

In one line (this site's summary): the narrowing is slow; the rupture of a plaque, the thrombosis that follows and the complete blockage of the vessel are sudden. The same leaflet states in its introduction: "Acute Myocardial Infarction (AMI) or more specifically ST Elevation Myocardial Infarction (STEMI), commonly known as heart attack is a life-threatening disease. It is usually caused by blockages of major coronary arteries which cause damage to heart muscle. Early medical attention and management are important."

⚠️ The official material also states that there may be no sensation at all. The Hospital Authority's SmartPatient page on coronary heart disease states: "It takes a long time for atherosclerosis to develop. There may not be any symptoms for the narrowing of blood vessels." The Department of Health's Elderly Health Service page on coronary heart disease (the footer date does not identify the content version) separately states: "About 10% of patients with coronary heart disease do not have symptoms and only present as sudden death." ⚠️ That page prints no year, no source and no study population details or sample size for the "10%". This article quotes it as that page writes it and makes no further statement about the proportion.

Who most needs to know: people who already know they have high blood pressure, diabetes or high blood lipids, and people who want to be clear whether "angina" and "a heart attack" are the same thing.

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#How many people die of heart disease in Hong Kong each year? Where does it rank?

In the Centre for Health Protection's "Number of registered deaths by leading cause of death, 2001 - 2025", ranked by the number of registered deaths in 2025, diseases of heart come third. The column heading for 2025 in that table prints "2025 #", and the note below the table prints "# Provisional figures."

What share of all deaths in Hong Kong? The Centre for Health Protection's Heart Diseases health topic page (the page itself prints 31 March 2026) states, for 2024: "They were the third commonest cause of deaths in Hong Kong, accounting for 12.6% of all registered deaths." ⚠️ This site has not seen the Centre print the corresponding proportion for 2025 on any official page, so this article gives no share for 2025.

How do the figures split by sex? The Centre for Health Protection's "Number of registered deaths by leading cause of death, sex and age group in 2025" prints, on the heart row under "All ages": male 3,792, female 2,801 (2025, provisional figures). ⚠️ These are numbers of deaths, not death rates. Counts are affected by the size and age structure of the male and female populations. The next section explains why rates and counts have to be read separately; crude and age-standardised death rates by sex appear in the section after that.

⚠️ The official sources are not consistent with each other, and this article says so plainly. The Hospital Authority's SmartPatient page on coronary heart disease states: "Heart and cerebrovascular disease rank second after cancer as a cause of death in Hong Kong." The Department of Health's Elderly Health Service page on coronary heart disease states: "Heart disease is the second killer disease (second only to cancer) in Hong Kong." Those are the two pages' own words and this article quotes them as printed; but this article does not treat "second killer" as the current ranking — in the Centre for Health Protection's mortality table, on both the 2024 and the 2025 (provisional) figures, diseases of heart rank behind malignant neoplasms and pneumonia, that is, third. The ranking used here is that of the Centre for Health Protection's mortality table.

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#Is the death rate rising or falling? (This is the easiest place to go wrong)

Two rates, one Centre, the same span of years, opposite directions. The two Centre for Health Protection tables print the following:

Why does this happen? The Centre for Health Protection prints its own explanation above the age-standardised table:

Since death rates for most diseases are strongly age-dependent and typically increase with age, direct comparisons of crude death rates over time can be highly misleading if the underlying age structure of the population has changed. Therefore, age-standardised death rates for the leading causes of death, which eliminate the effect of changes in age composition, are also presented in the following table to enable valid intertemporal comparisons.

⚠️ That sentence has to travel with every crude death rate. This site's calculation, from the two tables above: the crude death rate rose from 70.0 to 87.9, a rise of about 26%; the age-standardised death rate fell from 52.3 to 30.1, a fall of about 42%. Those two percentages are this site's calculation; the Centre for Health Protection does not print them. Quote only one of the two and you arrive at the opposite conclusion.

This is not peculiar to heart disease. On the "All causes" row of the same two tables: the crude death rate rose from 496.0 to 690.1, while the age-standardised death rate fell from 381.3 to 244.9 over the same period. ⚠️ In other words, the divergence is not specific to heart disease; the two all-cause figures also show that the trend before and after age standardisation can differ — which is exactly what the Centre's own explanation says.

Who most needs to know: anyone who sees a headline saying heart disease deaths have "hit a record high" or "fallen sharply" and wants to know which figure is being quoted.

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#What share of heart disease deaths is coronary heart disease? (Three official figures, three different bases)

The most recent is 52.9%, for 2024, both sexes. The "Situation in Hong Kong" section of the Centre for Health Protection's Heart Diseases health topic page (the page itself prints 31 March 2026) reads in full, from the sentence beginning with 2024 to the end of the paragraph, as follows (nothing omitted):

In 2024, heart diseases claimed about 88 900 inpatient discharges and inpatient deaths in all hospitals †, and 6 594 registered deaths ‡. They were the third commonest cause of deaths in Hong Kong, accounting for 12.6% of all registered deaths. The crude death rates of heart diseases were 109.1 for males and 69.7 for females per 100 000 population of respective sex. Coronary heart disease was the dominating component, making up 52.9% of heart disease deaths. The crude death rates due to coronary heart disease were 65.3 for males and 30.6 for females per 100 000 population of respective sex. The age-standardised death rates * of heart diseases were 43.7 for males and 20.5 for females per 100 000 standard population. The age-standardised death rates due to coronary heart disease were 26.9 for males and 9.2 for females per 100 000 standard population.

The notes on the same page read: "†" — "Include both inpatient discharges and inpatient deaths in all hospitals with heart diseases as the principal diagnosis in that episode of hospitalisation."; "‡" — "Include registered deaths with heart diseases as the underlying cause of death."; "*" — "Age-standardised death rates are compiled based on the world standard population specified in GPE Discussion Paper Series: No.31, EIP/GPE/EBD, World Health Organization, 2001."

⚠️ The warning in the previous section applies here too. 109.1 (male) and 69.7 (female) are crude death rates, per 100 000 population of the respective sex; 43.7 (male) and 20.5 (female) are age-standardised death rates, per 100 000 standard population. The two pairs are printed on the same page, in the same paragraph, for the same year (2024); their bases differ and they are not interchangeable. The same applies to the coronary heart disease pair: crude death rates male 65.3 / female 30.6, age-standardised death rates male 26.9 / female 9.2. A crude death rate can describe the actual mortality burden in that year's population; to compare the gap with the effect of age structure removed, you need the age-standardised rates.

But two further official figures exist, on different bases:

The original wordings are, respectively — Centre for Health Protection men's page: "Heart disease is one of the main killers in men of Hong Kong, accounting for 3,730 registered deaths in men in 2024. Coronary heart disease accounted for approximately 60% of all heart diseases related deaths in men."; Hospital Authority SmartPatient: "According to statistics from the Department of Health, coronary heart disease deaths accounted for 66.6% of all deaths caused by heart disease in 2015."

⚠️ The three figures do not contradict one another; they rest on different bases: both sexes in 2024, males only (the sentence itself prints no year, the year being carried over from the "2024" in the preceding sentence), and older 2015 data. This article uses the dated, both-sexes figure (52.9%, 2024) as the comparison baseline, and lists the other two on the bases their own pages print, without treating them as the same thing. ⚠️ Note also that the 3,730 on the men's page is a 2024 male figure, and is a different year from the 3,792 (2025, provisional) taken above from "Number of registered deaths by leading cause of death, sex and age group in 2025"; the two must not be run together.

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#How do the official sources describe the warning signs of a heart attack?

This whole section is official text. This article writes no symptom list of its own and adds nothing to, or removes nothing from, the quotations. What follows is the text of the relevant passage in each document; this article does not merge the five documents into a single list, and does not claim that every symptom on every page has been captured.

The "Heart disease" section of the Fire Services Department's "How to call an ambulance" page opens as follows:

Heart disease is a life threatening emergency. It is caused by insufficient supply of blood and oxygen to the heart muscle due to narrowing or blocking of the coronary arteries. Part of the heart muscle will die if oxygen deficiency persists.

The signs and symptoms that the Department itself lists in the same section:

Signs and symptoms of heart disease
1. Severe pain in middle part of the chest, it is often of a gripping nature and will last for a few minutes. The pain may be mistaken as indigestion;
2. The pain migrates from the chest to the arms, shoulders, neck, lower jaw, middle part of the back or cardia;
3. Profuse perspiration;
4. Nausea and vomiting;
5. Extreme weakness;
6. The patient feels anxious and frightened;
7. The skin appears pale, while finger nails and lips turn blue;
8. Shortness of breath.

The "Symptoms" section of the Centre for Health Protection's Heart Diseases health topic page:

People with coronary heart disease may experience central crushing chest pain, precipitated by exertion and relieved by rest. The pain may radiate to the arm, shoulder, neck and jaw. It is of greater severity and longer duration in a heart attack. Other symptoms include palpitation, dizziness, sweating, nausea and weakness. It may be associated with breathlessness and bilateral leg swelling when the patient is in heart failure.

The "Myocardial infarction (heart attack)" item on the Hospital Authority's SmartPatient page on coronary heart disease:

Myocardial infarction (heart attack): When the patient has a heart attack, chest pain will become more severe and last longer. It may continue even after the patient has taken a rest or medicine. Other possible symptoms may include heart palpitations, light-headedness, sweating, nausea and extreme fatigue. Emergency treatment is needed in this case.

The "Symptoms and Diagnosis" section of the Hospital Authority's Acute Myocardial Infarction leaflet (PILIC0329E version 2.0, effective date 6 January 2020, last review date 15 March 2024):

Typical symptoms of AMI include chest pain and discomfort, sometimes radiating to jaw and left arm. Other symptoms include sweating, diaphoresis and shortness of breath. Atypical symptoms like dyspepsia, indigestion and dizziness can also be due to AMI. Sometimes, cardiac arrest may be the first presentation of AMI.

⚠️ The four official passages above (Fire Services Department, Centre for Health Protection, Hospital Authority SmartPatient, Hospital Authority leaflet) have points in common and points each adds on its own (this site's summary): the Centre for Health Protection passage stresses that the pain is "relieved by rest"; the Hospital Authority SmartPatient passage states that in a heart attack the chest pain "may continue even after the patient has taken a rest or medicine"; the Fire Services Department list states that the pain "may be mistaken as indigestion"; the Hospital Authority leaflet states that atypical symptoms include dyspepsia, indigestion and dizziness, and also that cardiac arrest may be the first presentation.

What do the official sources themselves say to do next? These are their own words; this article has not rewritten them:

• The Department of Health's Elderly Health Service page on coronary heart disease first sets out the signs of acute myocardial infarction: "Acute myocardial infarction (heart attack) - Sudden onset of severe chest pain that may radiate to the neck, arm or jaw. The patient may develop profuse sweating, shortness of breath, nausea and vomiting or even pass out." The sentence that follows is: "Anyone with these symptoms should immediately seek medical treatment or attend the Accident & Emergency Department in a hospital."
• The "Treatment of patient suffering from heart disease" section of the Fire Services Department's "How to call an ambulance" page: "1. Gently place the patient in a comfortable position; 2. Undo the patient's clothing, especially clothing around the neck; 3. Make sure there is fresh air for the patient; 4. Use a blanket or jacket to keep the patient warm; 5. Keep the patient calm."
• The Hospital Authority's SmartPatient page on coronary heart disease states, on myocardial infarction: "Emergency treatment is needed in this case."
• The Hospital Authority's Acute Myocardial Infarction leaflet: "AMI is a LIFE-THREATENING disease and once a diagnosis of AMI is made or suspected, early treatment is important to reduce the chance of death or major complications."

These are the departments' own instructions on seeking care. This article cannot judge any individual case. The emergency number, what the Fire Services Department will ask once the call connects, and the Accident & Emergency triage system are covered below under "Calling an ambulance and going to the Accident & Emergency Department".

Who most needs to know: carers with an older person at home who want to know what signs and what steps the official documents set down.

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#What are the risk factors, and how many people in Hong Kong have them?

The "Risk factors" section of the Centre for Health Protection's Heart Diseases health topic page:

There are many risk factors for coronary heart disease and many of them are preventable or treatable. They include hypertension, hyperlipidemia, smoking, diabetes mellitus, obesity, lack of physical activity and chronic stress. Family history of the disease also increases the risk.

The Hospital Authority's SmartPatient page on coronary heart disease groups the risk factors into three types (as printed on that page, including its own bracketing): "Lifestyle Unhealthy diet (A healthy diet should be low salt, low sugar, low fat and high fibre; five portions of vegetable and fruit should be eaten per day) Lack of exercise Overweight and obesity Smoking Stress Chronic diseases Hypertension Diabetes Hyperlipidaemia Environmental Air pollution Noise pollution"

How many people in Hong Kong have these risk factors? The figures below come from the Report of Population Health Survey 2020-22 (Part II) by the Non-Communicable Disease Branch of the Centre for Health Protection, Department of Health (the report prints the year 2023). ⚠️ Each figure carries its own definition and age range; change the definition and the figure changes.

⚠️ "Half the population is overweight" or "fewer than a third"? Three things change at once, not just the cut-off. Between 54.6% and 30.8%, the age range (15-84 against 18-84), whether the figure is age-standardised (crude against age-standardised) and the BMI cut-offs (Asian adult classification against WHO classification) all differ, so the two cannot be said to describe the same group of people, and the whole of the gap cannot be attributed to the cut-offs alone. The report itself prints a directly comparable pair: in the sentence immediately before the one giving 30.8%, it states that for persons aged 18-84 the age-standardised prevalence of overweight and obesity under the Asian adult classification is 51.3% (crude prevalence 55.1%). The two sentences read as follows (page 13 of that report):

According to the Asian BMI classification (i.e. overweight BMI ≥ 23.0 kg/m2; obesity BMI ≥ 25.0 kg/m2), the age-standardised prevalence of overweight and obesity was 51.3% in persons aged 18-84 years (Crude prevalence: 55.1%). According to WHO's BMI classification (i.e. overweight BMI ≥ 25.0 kg/m2; obesity BMI ≥ 30.0 kg/m2), the age-standardised prevalence of overweight and obesity was 30.8% in persons aged 18-84 years (Crude prevalence: 32.8%).

⚠️ Both classifications are the World Health Organization's. One is the classification of BMI categories for Asian adults adopted by that organisation's Western Pacific Regional Office (overweight ≥ 23.0, obesity ≥ 25.0); the other is that organisation's global BMI classification (overweight ≥ 25.0, obesity ≥ 30.0). It is not the case that one is "the WHO figure" and the other is not.

⚠️ The same situation arises for hypertension, diabetes and blood cholesterol. After the 29.5%, the report separately prints an age-standardised prevalence of raised blood pressure for persons aged 18-84 (defined as systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg disregarding known history of hypertension) of 15.0% (crude prevalence 19.4%); after the 8.5% it prints 4.6% (crude prevalence 6.9%); after the 51.9% it prints 45.0% (crude prevalence 49.7%). Each age-standardised figure uses its own definition and the 18-84 age range, as set out row by row in the table above. The same report, with different definitions, different age ranges and with or without standardisation, produces different figures.

So how many people have actually been diagnosed by a doctor with coronary heart disease? The Centre for Health Protection's Heart Diseases health topic page cites the same survey: "Population Health Survey (PHS) 2020-22 revealed that 1.6% of persons aged 15 or above reported doctor-diagnosed coronary heart disease, with a higher prevalence in males (2.1%) than in females (1.2%). The prevalence increased with age, from 0.1% for people aged 15-24 to 7.7% for people aged 85 or above." ⚠️ Note that the frame here is "aged 15 or above", not the "15-84" of the table above.

⚠️ The Centre for Health Protection's men's page separately states: "One of the causes of coronary heart disease is overweight or obesity. About 38% of men in Hong Kong are overweight or obese." That page prints no year, no source and no definition of which BMI cut-offs "overweight or obese" refers to, so this article does not use the 38% for any comparison.

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#Calling an ambulance and going to the Accident & Emergency Department: what do the official sources say?

The emergency number and the response time target. The number set out on the Fire Services Department's "How to call an ambulance" page is the 999 Hotline, or the Fire Services Communication Centre direct at 2735 3355. The Fire Services Department's "Performance Pledge" page reads: "Emergency ambulance calls within 12 minutes from the time of call to the arrival of an ambulance at the street address. Our target is to meet this response time in 92.5% of all emergency calls."

⚠️ The Fire Services Department states what it will ask once you call. The "How to call an ambulance" page sets out the information the caller should give: "1. What has happened ( e.g. someone faints, sustains injuries or is ill ); 2. Detailed location of the incident; 3. Brief description of the patient's condition ( e.g. age, sex, history, symptoms, signs, seriousness of injury, number of people involved, etc ); 4. Contact telephone number."

The Government's Hong Kong: The Facts — Fire Services (the last page prints "September 2025" and "Figures in this Factsheet are as of 31 December, 2024") states: "In 2024, the Command responded to 823,655 calls, representing an average of 2,250 calls a day, and conveyed a total of 742,351 casualties or patients to hospitals or clinics." The same fact sheet also states that the Fire Services Department offers post-dispatch advice by phone after dispatching ambulances to scenes, that all personnel of the Fire Services Communications Centre are trained emergency medical dispatchers, and that with the aid of a computer system they are able to offer immediate, comprehensive and appropriate first aid advice on "more than 30 types of injury and sickness, covering, among others, traumatic injuries, choking, unconscious/fainting and cardiac or respiratory arrest".

How does the Fire Services Department describe the overall purpose of the emergency ambulance service? The opening paragraph of the "How to call an ambulance" page, written before that page says anything about any particular emergency:

The Fire Services Department provides emergency ambulance service to residents within the territory, including outlying islands. In case a person, having an emergency or injury, is unable to seek medical attention on his own, he can call the 999 Hotline or the Fire Services Communication Centre at 2735 3355 for emergency ambulance service. If circumstances permit and his condition is not too serious, he should go to the hospital by other means.

⚠️ That paragraph is the page's opening statement about the ambulance service as a whole; it is not what the page says about heart disease. Further down, the "Heart disease" section of the same page opens with a different sentence: "Heart disease is a life threatening emergency." This article does not merge the two, and makes no judgement about whether any particular situation counts as a condition that is "not too serious".

The Accident & Emergency triage system. Q8 of the Hospital Authority's "Public Healthcare Fees and Charges Reform - FAQ" page (the page carries no self-printed date):

To ensure that citizens with urgent needs can receive timely services, A&E Departments implement a patient triage system under which patients are classified into five triage categories, namely Category I (Critical), Category II (Emergency), Category III (Urgent), Category IV (Semi-urgent), and Category V (Non-urgent) based on their clinical conditions, and will receive treatment as prioritised by their urgency category.

Q9 on the same page: "Triage assessment is conducted by triage nurses, who determine triage category of patient after registration. If necessary, re-assessment may be performed to reflect the updated clinical condition of patient."

⚠️ Triage is done by triage nurses, not by the patient and not by this article. This article does not define which situation falls into which triage category.

⚠️ This article makes no statement about whether the emergency ambulance service is charged for. Not one of the four Fire Services Department and Government documents quoted here ("How to call an ambulance", "Performance Pledge", the Ambulance Services in Hong Kong PDF, and the Government's Hong Kong: The Facts — Fire Services; URLs at the end of this article) states that the Fire Services Department's emergency ambulance service is provided free of charge. That does not mean no official source has ever published the point. ⚠️ Incidentally, the word "free" appears three times in the Fire Services Department's Ambulance Services in Hong Kong PDF, and all three times it refers to two other organisations: "The Auxiliary Medical Service (AMS) provides a free NEATS to the public of the HKSAR."; "Hong Kong St. John Ambulance Brigade (St. John Ambulance) provides Hong Kong citizens with free ambulance services."; and "Other than the above free services, St. John Ambulance also provides NEATS at a charge for patients of private hospitals from home to hospital or hospital to home."

Who most needs to know: people who want to know which number the official documents give, what the response time target is, and how triage works at the Accident & Emergency Department.

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#Fees and waiting times in the public system: what do the official sources say?

Accident & Emergency fees. Q1 of the Hospital Authority's "Public Healthcare Fees and Charges Reform - FAQ" page: "The new A&E fees for Eligible Persons will be revised from $180 to $400, taking effect from 1 Jan 2026." ⚠️ The $400 is the charge for "Eligible Persons", which is that page's own term; this article does not quote the charge for Non-eligible Persons and makes no statement about who counts as an Eligible Person.

The $400 has an exemption. A&E Q2 on the same page states that among Eligible Persons, patients triaged as Category I (Critical) or Category II (Emergency) are exempted from the A&E attendance fee. Triage is assessed by a nurse according to clinical condition; the exemption does not mean that every heart patient is automatically placed in the same category.

How long is the wait for a specialist clinic? Among the Hospital Authority's specialist out-patient waiting time pages — Ear, Nose & Throat, Ophthalmology, Gynaecology, Medicine, Orthopaedics & Traumatology, Paediatrics, Psychiatry and Surgery — there is no separate page for Cardiology. That is the scope of those eight pages; it does not mean that no official cardiology data has ever been published.

What can be quoted is the figure for Medicine (not Cardiology):

The same page also prints the Hospital Authority's target: "HA's targets are to maintain the median waiting time of Urgent and Semi-urgent cases within two weeks and eight weeks respectively."

⚠️ Three things to note: first, this is Medicine, not Cardiology; second, the "Longest" column is, per that page's note, the 90th percentile, not the longest case; third, the page is broken down by the pre-merger cluster boundaries, Hong Kong East and Hong Kong West having been integrated on 1 April 2026, with the page itself stating that the information will be updated in due course.

If you really are having a heart attack, do you have to pay for the "balloon" procedure? The "Fees and Charges" section of the Hospital Authority's Acute Myocardial Infarction leaflet:

PPCI for acute STEMI is a life-saving procedure. Costs are covered by Hospital Authority and you do not need to pay for the consumables.
Nevertheless, after the acute phase, subsequent PCI to other coronary stenosis may be required. The procedures may involve use of consumables which are 'Privately Purchased Medical Items'. Financial arrangement is needed before the procedure.

⚠️ This passage deals with two situations — emergency (primary PCI) and non-emergency — whose charging arrangements differ, and the leaflet itself separates them. The same section continues immediately after those two points with three further points, all of which this article quotes in order:

You need to pay an estimated deposit. The final charge, however, depends on the number of medical devices and consumables used. The principle of actual cost charging applies. After the procedure, you may need to pay the balance to or collect refund from the account office.
Please note that the procedure may further need to be staged or repeated for various reasons. Separate charging is required for each procedure.
If you have financial difficulty, you can apply for assistance through our medical social worker.

Who most needs to know: people who want to know how fees and follow-up appointments in the public system are written down.

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#Does the Government screen for heart disease?

There is a scheme that screens for cardiovascular risk factors, but it does not screen for heart disease. The stated objective on the introduction page for the Chronic Disease Co-Care Scheme run by the Primary Healthcare Commission (the page footer prints "Last Review Date: 26 January 2026"):

"CDCC Scheme" - To provide convenient screening services for chronic diseases (including DM and HT) and blood lipid testing, allowing for a comprehensive approach to the assessment and proper management of cardiovascular disease risk factors, including the "three highs"

The eligibility criteria read: "Hong Kong residents* aged 45 or above; and No known medical history of diabetes mellitus (DM) or hypertension (HT)". The note against the "*" reads: "Holding (1) a valid Hong Kong Identity Card within the meaning of the Registration of Persons Ordinance (Cap. 177), except those who obtained their Hong Kong Identity Card by virtue of a previous permission to land or remain in Hong Kong granted to them and such permission has expired or ceased to be valid, or (2) a valid Certificate of Exemption within the meaning of the Immigration Ordinance (Cap.115)". The "Health Management Plan" section of the same introduction page sets out the number of subsidised visits: up to six subsidised visits per participant programme year for hypertension and/or diabetes mellitus; up to four for a specific blood sugar level of prediabetes; and, for a specified condition of dyslipidaemia only, up to four in the first participant programme year and up to two in each subsequent year.

⚠️ Neither of the two Chronic Disease Co-Care Scheme pages quoted here (the scheme introduction page and the eligibility page) states that the scheme includes coronary heart disease screening or any cardiac examination — the screening steps printed are that the family doctor performs assessment and arranges investigations for screening, arranges blood tests at a designated medical laboratory, and explains the investigation report and diagnosis and formulates an appropriate health management plan. That does not mean Hong Kong has no government cardiovascular examination arrangements; it means only that these two pages do not say so.

⚠️ Note also the eligibility condition the scheme itself prints: eligibility requires "No known medical history of diabetes mellitus (DM) or hypertension (HT)". This article quotes it as that page writes it and makes no statement about other routes for people already diagnosed.

So what examinations would a doctor use? The list of investigation and diagnostic methods on the Hospital Authority's SmartPatient page on coronary heart disease: "Taking the medical history of patients Physical examination including blood pressure Blood tests including sugar and lipid Electrocardiogram (ECG) Exercise ECG Echocardiogram (ultrasound of the heart) Computerized tomography coronary angiogram Magnetic resonance imaging of the heart Coronary angiogram". ⚠️ This is the list of methods set out on that page. It does not mean that everyone needs all of them, and it is not a recommendation by this article; which are used is decided by a doctor on the clinical situation.

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#Common questions

• Where exactly does heart disease rank in Hong Kong? According to the Centre for Health Protection's "Number of registered deaths by leading cause of death, 2001 - 2025", on the 2025 figures (provisional), diseases of heart account for 6,593 deaths, behind malignant neoplasms at 15,368 and pneumonia at 11,260 — that is, third. The Hospital Authority's SmartPatient page and the Department of Health's Elderly Health Service page still say "second"; this article quotes those two pages' wording as printed, but the ranking used here is that of the Centre for Health Protection's mortality table.

• Is the heart disease death rate rising or falling? It depends which rate. The Centre for Health Protection's crude death rate rose from 70.0 per 100 000 mid-year population in 2001 to 87.9 in 2025 (provisional); the age-standardised death rate (per 100 000 standard population) fell from 52.3 to 30.1 over the same period. The Centre itself writes on the age-standardised table: "Since death rates for most diseases are strongly age-dependent and typically increase with age, direct comparisons of crude death rates over time can be highly misleading if the underlying age structure of the population has changed."

• Are men really twice as likely to die of heart disease as women? It depends which rate. The Centre for Health Protection's Heart Diseases health topic page prints two pairs of figures for 2024: crude death rates (per 100 000 population of the respective sex) male 109.1, female 69.7; age-standardised death rates (per 100 000 standard population) male 43.7, female 20.5. The two pairs rest on different bases and are printed on the same page in the same paragraph; this article lists both pairs and does not quote either on its own.

• People say coronary heart disease is two-thirds of heart disease deaths — is that right? The 66.6% figure appears on the Hospital Authority's SmartPatient page on coronary heart disease, which itself states that it is Department of Health data for 2015. The Centre for Health Protection's Heart Diseases health topic page (the page prints 31 March 2026) gives 52.9% for 2024. There is also an "approximately 60%", on the Centre for Health Protection's common diseases in men page, referring to the proportion among male decedents; that sentence itself prints no year, the year being carried over from the "2024" in the preceding sentence. The three figures rest on different bases.

• Do the official sources say half of Hong Kong is overweight or obese? Part II of the Population Health Survey 2020-22 report gives a crude rate of 54.6% for persons aged 15-84, using the classification of BMI categories for Asian adults adopted by the Western Pacific Regional Office of the WHO (overweight ≥ 23.0, obesity ≥ 25.0 kg/m²). The same report, for persons aged 18-84 and using the same Asian classification, gives an age-standardised prevalence of 51.3% (crude prevalence 55.1%), and using the WHO global classification (overweight ≥ 25.0, obesity ≥ 30.0) an age-standardised prevalence of 30.8% (crude prevalence 32.8%). Between 54.6% and 30.8% the age range, whether the figure is age-standardised, and the BMI cut-offs all differ, so the two cannot be said to describe the same group of people.

• How do the official sources distinguish a heart attack from angina? The Hospital Authority's SmartPatient page on coronary heart disease states that in a heart attack "chest pain will become more severe and last longer. It may continue even after the patient has taken a rest or medicine", and states that "Emergency treatment is needed in this case". The Centre for Health Protection's heart disease page describes ordinary coronary heart disease angina as "precipitated by exertion and relieved by rest". This article makes no judgement about any individual case.

• How long is the wait for Cardiology? The eight Hospital Authority specialist waiting time pages quoted here contain no separate cardiology figures. The Medicine reporting period is 1 July 2025 to 30 June 2026: median for urgent cases less than 1 week to 1 week, semi-urgent 4 to 6 weeks, stable 27 to 65 weeks; the 90th percentile for stable cases is 50 to 98 weeks. These are overall Medicine figures, not Cardiology figures.

• How much does the Accident & Emergency Department cost? A&E Q1-Q2 of the Hospital Authority FAQ state that from 1 January 2026 the basic charge for Eligible Persons is $400, and that patients triaged as Category I (Critical) or Category II (Emergency) are exempted. Triage is determined by a nurse on the patient's condition.

Related article: 〈Waiting for a public specialist appointment and getting worse — can you ask to be seen earlier?〉

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#What this article covers

• This article does not state what share of heart disease deaths acute myocardial infarction accounts for. None of the 8 Centre for Health Protection pages and documents, the Hospital Authority SmartPatient coronary heart disease page and the Hospital Authority Acute Myocardial Infarction leaflet (PILIC0329E) quoted here — all URLs are in the sources below — prints that proportion or that death figure. What the Centre for Health Protection prints is that coronary heart disease made up 52.9% of heart disease deaths in 2024, not a proportion for acute myocardial infarction. That does not mean no official source has ever published it.
• This article makes no statement about whether the emergency ambulance service is charged for. Not one of the four Fire Services Department and Government documents quoted here ("How to call an ambulance", "Performance Pledge", the Ambulance Services in Hong Kong PDF, and the Government's Hong Kong: The Facts — Fire Services; URLs in the sources below) states that the Fire Services Department's emergency ambulance service is free. That does not mean no official source has ever published the point, and it does not mean a charge applies.
• The $400 Accident & Emergency fee is the basic charge for Eligible Persons; triage Categories I and II are exempted. This article does not judge anyone's triage category.
• This article gives no separate cardiology waiting time. The eight specialist pages listed contain no cardiology; the Medicine figures keep the original page's reporting period, triage categories, 90th percentile definition and pre-merger cluster limitation.
• This article does not claim that women's heart attack symptoms differ from men's. None of the 7 official documents describing cardiac symptoms quoted here (the Centre for Health Protection Heart Diseases health topic page in English, the same page in Traditional Chinese, the Centre for Health Protection common diseases in men page, the Hospital Authority SmartPatient coronary heart disease page, the Hospital Authority Acute Myocardial Infarction leaflet, the Department of Health Elderly Health Service coronary heart disease page, and the Fire Services Department "How to call an ambulance" page) says so. What the Centre for Health Protection publishes are death rates by sex, not differences in symptoms.
• This article does not claim that people with diabetes have different heart attack symptoms from anyone else. The same 7 documents do not say so. The Remarks in the Hospital Authority's Acute Myocardial Infarction leaflet state: "The risk quoted is in general terms. In special patient group (e.g. diabetics), the actual risk may be higher." — that is about procedural risk, not symptoms; and the passage in the same leaflet about atypical symptoms does not attribute atypical symptoms to any particular patient group. This article does not merge the two sentences.
• This article has written no symptom list of its own, and does not use its own words to tell the reader when to call an ambulance. Every warning sign and every step in this article is the relevant department's own text; this article quotes the relevant passage of each document, does not merge several documents into a single list, and does not claim to have captured every symptom on every page.
• This article does not judge whether any individual's situation is urgent, and does not define which situation falls into which Accident & Emergency triage category. Triage assessment is carried out by triage nurses under the Hospital Authority's guidelines.
• This article has read no value off the four charts at the foot of the Centre for Health Protection's heart disease page. Those four charts are SVG images embedded in that page (by the titles the page itself prints: number of registered deaths and crude death rate of heart diseases by sex, 1981 to 2024; age-standardised death rate of heart diseases by sex; number of registered deaths and crude death rate of coronary heart disease by sex; age-standardised death rate of coronary heart disease by sex), and this article has not read figures off the charts. The long series quoted here are the two tables covering 2001 to 2025; the 2024 crude and age-standardised death rates by sex are quoted from the running text printed on the same page, not from the charts.
• This article does not use the "38%" overweight-or-obese proportion from the Centre for Health Protection's common diseases in men page. That page prints no year, no source and no BMI definition.
• This article does not cite the Gazette notice or the list of charges itself for the $400 Accident & Emergency fee. That amount and the 1 January 2026 effective date are quoted as printed on the Hospital Authority's public healthcare fees and charges reform page.
• This article does not compare or recommend any hospital, clinic or doctor, and does not advise anyone on which route to care to take.
• This is health information, not medical advice, and it cannot assess any individual condition.
• This is the English edition. The Traditional Chinese edition is the authoritative version of this article. Quotations above are reproduced from the official English text published by the Government of the Hong Kong Special Administrative Region, not translated by this site.

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This is health information, not medical advice.

#Sources

• Centre for Health Protection, Department of Health, "Number of registered deaths by leading cause of death, 2001 - 2025" (the page footer prints "Revision Date: 2026/07/29"; the table covers 2001-2025): https://www.chp.gov.hk/en/statistics/data/10/27/380.html (Last updated: 2026-09-08)
• Centre for Health Protection, Department of Health, "Death rate by leading cause of death, 2001 - 2025" (the page footer prints "Revision Date: 2026/07/29"): https://www.chp.gov.hk/en/statistics/data/10/27/117.html (Last updated: 2026-09-08)
• Centre for Health Protection, Department of Health, "Age-standardised death rate by leading cause of death, 2001 - 2025" (the page footer prints "Revision Date: 2026/07/30"): https://www.chp.gov.hk/en/statistics/data/10/27/339.html (Last updated: 2026-09-08)
• Centre for Health Protection, Department of Health, "Number of registered deaths by leading cause of death, sex and age group in 2025" (the page footer prints "Revision Date: 2026/07/29"): https://www.chp.gov.hk/en/statistics/data/10/27/340.html (Last updated: 2026-09-08)
• Centre for Health Protection, Department of Health, "Heart Diseases" health topic page (the page prints 31 March 2026): https://www.chp.gov.hk/en/healthtopics/content/25/57.html; Traditional Chinese version https://www.chp.gov.hk/tc/healthtopics/content/25/57.html (Last updated: 2026-09-08)
• Centre for Health Protection, Department of Health, "Common Diseases in Men - Coronary Heart Disease" (the page footer prints "Revision Date: 2026/07/17"): https://www.chp.gov.hk/en/static/80035.html (Last updated: 2026-09-08)
• Non-Communicable Disease Branch, Centre for Health Protection, Department of Health, Report of Population Health Survey 2020-22 (Part II) (the report prints the year 2023): https://www.chp.gov.hk/files/pdf/dh_phs_2020-22_part_2_report_eng.pdf (Last updated: 2026-09-08)
• Elderly Health Service, Department of Health, "Coronary heart disease" (the footer date does not identify the content version): https://www.elderly.gov.hk/english/health_information/hypertension_heart_disease/chd.html (Last updated: 2026-09-08)
• Hospital Authority SmartPatient, "Coronary Heart Disease" (the page carries no self-printed date): https://www.smartpatient.ha.org.hk/en/smart-patient-web/disease-management/disease-information/disease/CoronaryHeartDisease (Last updated: 2026-09-08)
• Hospital Authority Central Committee on Cardiac Service, Acute Myocardial Infarction patient information leaflet (document no. PILIC0329E version 2.0; effective date 6 January 2020; last review date 15 March 2024): https://www.ekg.org.hk/pilic/public/Cardiac_PILIC/Cardiac_AcuteMyocardialInfarction_0329_eng.pdf (Last updated: 2026-09-08)
• Hospital Authority, "Public Healthcare Fees and Charges Reform - FAQ" (the page carries no self-printed date): https://www.ha.org.hk/ho/corpcomm/fncr/index-en.html; Traditional Chinese version https://www.ha.org.hk/ho/corpcomm/fncr/index-tc.html (Last updated: 2026-09-08)
• Hospital Authority, "Waiting Time for New Case Booking at Medicine Specialist Out-patient Clinics" (reporting period 1 July 2025 to 30 June 2026; the page prints a next update date of 30 October 2026): https://www.ha.org.hk/visitor/sopc_waiting_time.asp?id=4&lang=ENG (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, "How to call an ambulance" (the page carries no self-printed date): https://www.hkfsd.gov.hk/eng/source/safety/uambu.htm (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, "Performance Pledge" (the page footer prints "Revision Date: 15 May 2026"): https://www.hkfsd.gov.hk/eng/aboutus/performance.html (Last updated: 2026-09-08)
• Hong Kong Fire Services Department, Ambulance Services in Hong Kong (the document carries no self-printed date): https://www.hkfsd.gov.hk/eng/source/safety/Ambulance_Services_in_HK.pdf (Last updated: 2026-09-08)
• Government of the Hong Kong Special Administrative Region, Hong Kong: The Facts — Fire Services (the last page prints "September 2025" and "Figures in this Factsheet are as of 31 December, 2024"): https://www.gov.hk/en/about/abouthk/factsheets/docs/fire_services.pdf (Last updated: 2026-09-08)
• Primary Healthcare Commission, "Introduction to the 'Chronic Disease Co-Care Scheme' and the 'Hepatitis B Co-care Scheme'" and "Eligibility" (both page footers print "Last Review Date: 26 January 2026"): https://www.primaryhealthcare.gov.hk/cdcc/en/gp/introduction.html, https://www.primaryhealthcare.gov.hk/cdcc/en/gp/join_cdcc_enrol_now.html (Last updated: 2026-09-08)

Official arrangements and statistics may be updated; the announcements of the departments concerned prevail. This is health information, not medical advice, and it cannot assess any individual condition. After listing the signs of acute myocardial infarction (the signs that page lists are quoted above under "How do the official sources describe the warning signs of a heart attack?"), the Department of Health's Elderly Health Service page states: "Anyone with these symptoms should immediately seek medical treatment or attend the Accident & Emergency Department in a hospital." For how to call for emergency ambulance service, see the Fire Services Department's "How to call an ambulance" page: call the 999 Hotline or the Fire Services Communication Centre at 2735 3355.