Guideline-adherent therapy in patients with cardiovascular diseases in Taiwan
Journal
Journal of the Formosan Medical Association
Journal Volume
114
Journal Issue
10
Pages
1000-1007
Date Issued
2015
Author(s)
Yin W.-H.
Huang C.-C.
Chuang S.-Y.
Yeh H.-I.
Fang C.-C.
Lin T.-H.
Wang K.-Y.
Tseng W.-K.
Huang L.-C.
Ueng K.-C.
Hsieh I.-C.
Li Y.-H.
Pan W.-H.
Chen J.-W.
Taiwanese Secondary Prevention for Patients with AtheRosCLErotic Disease (T-SPARCLE) Registry Investigators
Abstract
Background/Purpose: Aggressive and persistent control of risk factors is recommended for prevention of secondary comorbidities in patients with cardiovascular diseases. This study aimed to evaluate guideline recommendations for achieving targets for lipid and blood pressure (BP) control in patients with cardiovascular diseases in Taiwan. Methods: This multicenter cohort study was conducted in 14 hospitals in Taiwan. A total of 3316 outpatients who had established cerebrovascular disease (CVD), coronary artery disease (CAD), or both were recruited. Risk factors for comorbid conditions such as high BP, sugar, hemoglobin A1C, abnormal lipids, lipoproteins, and medication use were compared between patients with CVD, CAD, or both. Results: Of all patients, 503 (15.2%) had CVD only, 2568 (77.4%) had CAD only, and 245 (7.4%) had both CVD and CAD. Compared with patients who had only CAD, those with CVD were older, had higher frequency of hypertension, and lower frequency of diabetes mellitus. Patients with CAD were more likely to receive lipid-lowering and antihypertensive drugs than those with CVD (p < 0.001). Only 54.8% and 55.9% of patients achieved the recommended lipid and BP control targets, respectively. Patients with CVD (adjusted odds ratio: 0.61; 95% confidence interval: 0.48-0.78; p < 0.001) and women (adjusted odds ratio: 0.65; 95% confidence interval: 0.55-0.78; p < 0.001) were less likely to achieve the recommended lipid and BP targets. Conclusion: The guideline-recommended targets for lipids and BP in patients with CAD and CVD were still suboptimal in Taiwan. Greater efforts are required to achieve the targets, particularly in patients with CVD and in women. ? 2013.
SDGs
Other Subjects
acetylsalicylic acid; alpha adrenergic receptor blocking agent; angiotensin receptor; antihypertensive agent; antilipemic agent; beta adrenergic receptor blocking agent; calcium channel blocking agent; cilostazol; clopidogrel; dipyridamole; diuretic agent; glucose; hemoglobin A1c; insulin; lipid; lipoprotein; oral antidiabetic agent; ticlopidine; lipid; aged; Article; blood pressure regulation; cardiovascular disease; cerebrovascular disease; clinical practice; cohort analysis; coronary artery disease; diabetes mellitus; female; human; hypertension; lipid blood level; major clinical study; male; multicenter study; practice guideline; risk factor; Taiwan; blood; blood pressure; Cerebrovascular Disorders; clinical trial; comorbidity; complication; coronary artery disease; drug effects; middle aged; practice guideline; protocol compliance; statistical model; Aged; Antihypertensive Agents; Blood Pressure; Cerebrovascular Disorders; Cohort Studies; Comorbidity; Coronary Artery Disease; Female; Guideline Adherence; Humans; Hypertension; Lipids; Logistic Models; Male; Middle Aged; Practice Guidelines as Topic; Risk Factors; Taiwan
Type
journal article