ABSTRACT
Background: Currently, “multiple risk factor reduction program” for coronary heart disease (CHD) risk is proposed in Thailand, but there is little information about its effectiveness for Thai hypertensive patients. Objectives: To investigate the effectiveness of the CHD risk program among hypertensive patients in Thai community hospitals. Material and methods: Seven hundred eighty one hypertensive patients (aged 35-64 years) were selected from four hospitals in Sisaket, Thailand between Sept 2007 and Aug 2008. The intervention program included: a) provide training about the overview of CHD and global risk assessment, and b) patient training about risk factor modification skill. The control subjects received health education and usual care. The program effectiveness was evaluated using changes in the RAMA-EGAT heart score and risk factors, such high density lipoprotein cholesterol or serum total cholesterol, one year after the program implementation. Data analysis was conducted using “t”-test for the pre-post difference between the intervention and control groups. Results: The changes in the RAMA-EGAT heart score were -0.03 vs +0.09 for the intervention and control groups, respectively. Changes in high density lipoprotein cholesterol, waist circumference, systolic, diastolic, and serum total cholesterol were statistically significant between for the both groups. The CHD knowledge was improved significantly between the both groups, but the smoking quit-rate was not significantly different. There was a significant association of intervention with the improvement in knowledge score, HDL-C, and waist circumference, but blood pressure and serum total cholesterol levels in the control were reduced greater than those in the intervention groups. Conclusion: This program did not sufficiently reduce the change global risk score, but some risk factors were improved significantly. The global risk assessment should be integrated with behavior counseling and treatment activity for hypertensive patients.