ABSTRACT
<p><b>INTRODUCTION</b>Atherosclerotic cardiovascular disease is a global health burden. However, there are heterogeneities among countries or regions in the risk factors and clinical manifestations of atherosclerotic diseases as well as management patterns.</p><p><b>METHODS</b>We collected data from 25 centres in Thailand. Patients with documented coronary artery disease, cerebrovascular disease or peripheral arterial disease, or with at least three atherosclerosis risk factors were enrolled between April 2011 and March 2014. Data on demographics, atherosclerosis risk factors and the management pattern of risk factors, including laboratory findings, were recorded.</p><p><b>RESULTS</b>In total, 9,390 patients, including 4,861 patients with established atherosclerotic disease and 4,529 patients with multiple risk factors, were enrolled. The modifiable risk factors, other than current smoking habit (5.3%), were common: hypertension (83.8%), dyslipidaemia (85.9%) and diabetes mellitus (57.4%). A majority of patients with hypertension (96.3%), dyslipidaemia (93.8%) and diabetes mellitus (78.5%) received medications for their conditions. Antiplatelet agents were given to 73.9% of patients. The undertreatment rate of cardiovascular risk factors, such as blood pressure, low-density lipoprotein cholesterol, haemoglobin A1c and smoking status, was 35.8%, 59.0%, 45.3% and 5.3%, respectively.</p><p><b>CONCLUSION</b>Conventional atherosclerosis risk factors were common among Thai patients with established atherosclerotic disease. Even though most of the patients received recommended treatments according to established guidelines, a significant proportion of them were undertreated for atherosclerosis risk factors.</p>
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.