Jiann-Shing Jeng1, Wei-Hsian Yin2, Chin-Chou Huang3, Shao-Yuan Chuang4, Hung-I Yeh5, Ching-Chang Fang6, Tsung-Hsien Lin7, Kuo-Yang Wang8, Wei-Kung Tseng9, Lien-Chi Huang10, Kwo-Chang Ueng11, I-Chang Hsieh12, Yi-Heng Li13, Wen-Harn Pan4, Chau-Chung Wu14, Jaw-Wen Chen3. 1. Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan. 2. Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan. 3. Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan. 4. Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan. 5. Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan. 6. Office of Vice Superintendent on Medical Affairs, Tainan Municipal Hospital, Tainan, Taiwan. 7. Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan. 8. Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Chung-Shan Medical University, Taichung, Taiwan. 9. Department of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan. 10. Department of Cardiology, Taipei Union Hospital, Taipei, Taiwan. 11. School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan. 12. Second Department of Cardiology, Chang-Gung Memorial Hospital, New Taipei City, Taiwan. 13. Department of Internal Medicine, National Cheng Kung University Hospital and National Cheng Kung University, Tainan, Taiwan. 14. Division of Cardiology, Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Department of Primary Care Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: chauchungwu@ntu.edu.tw.
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.
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.