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Management of atherosclerosis risk factors for patients at high cardiovascular risk in real-world practice: a
Arintaya Phrommintikul1, Rungroj Krittayaphong2, Wanwarang Wongcharoen1
1Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Insights
Atherosclerosis risk factors like hypertension and diabetes are common in Thailand. Despite guideline-based treatments, many patients remain undertreated for these cardiovascular risks.
Area of Science:
- Cardiology
- Public Health
- Epidemiology
Background:
- Atherosclerotic cardiovascular disease poses a significant global health challenge.
- Regional variations exist in risk factors, clinical presentation, and management of atherosclerotic diseases.
Purpose of the Study:
- To investigate the prevalence of atherosclerosis risk factors in Thai patients.
- To evaluate the management patterns and treatment undertreatment rates for these risk factors in Thailand.
Main Methods:
- Data collected from 25 centers in Thailand (April 2011-March 2014).
- Included patients with established atherosclerotic disease or at least three risk factors.
- Recorded demographics, risk factors, management, and laboratory findings.
Main Results:
- 9,390 patients enrolled; common risk factors include hypertension (83.8%), dyslipidemia (85.9%), and diabetes mellitus (57.4%).
- Most patients received medications for hypertension, dyslipidemia, and diabetes.
- Significant undertreatment rates observed for blood pressure (35.8%), LDL cholesterol (59.0%), HbA1c (45.3%), and smoking cessation (5.3%).
Conclusions:
- Conventional atherosclerosis risk factors are highly prevalent in Thai patients with established atherosclerotic disease.
- While treatments are often guideline-adherent, a substantial undertreatment of modifiable risk factors persists.
Introduction:
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.
Methods:
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.
Results:
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.
Conclusion:
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.
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