1. Reduction in cardiovascular risk using a proactive multifactorial intervention is consistent among patients residing in Pacific Asian and non-Pacific Asian regions: a CRUCIAL trial subanalysis.
- Author
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Cho EJ, Kim JH, Sutradhar S, Yunis C, and Westergaard M
- Subjects
- Aged, Amlodipine adverse effects, Antihypertensive Agents adverse effects, Asia epidemiology, Calcium Channel Blockers adverse effects, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Diabetes Mellitus epidemiology, Drug Combinations, Dyslipidemias diagnosis, Dyslipidemias epidemiology, Europe, Female, Heptanoic Acids adverse effects, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors adverse effects, Hypertension diagnosis, Hypertension epidemiology, Latin America, Male, Middle Aged, Middle East, Prospective Studies, Pyrroles adverse effects, Risk Assessment, Risk Factors, Time Factors, Treatment Outcome, Amlodipine therapeutic use, Antihypertensive Agents therapeutic use, Calcium Channel Blockers therapeutic use, Cardiovascular Diseases prevention & control, Dyslipidemias drug therapy, Heptanoic Acids therapeutic use, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypertension drug therapy, Preventive Health Services, Pyrroles therapeutic use
- Abstract
Background: Few trials have compared different approaches to cardiovascular disease prevention among Pacific Asian (PA) populations. The Cluster Randomized Usual Care versus Caduet Investigation Assessing Long-term-risk (CRUCIAL) trial demonstrated that a proactive multifactorial intervention (PMI) approach (based on single-pill amlodipine/atorvastatin) resulted in a greater reduction in calculated Framingham 10-year coronary heart disease (CHD) risk compared with usual care (UC) among hypertensive patients with additional risk factors. One-third of CRUCIAL patients resided in the PA region. The aim of this subanalysis was to compare two approaches to cardiovascular risk factor management (PMI versus UC) among patients residing in PA and non-PA regions., Methods: This subanalysis of the CRUCIAL trial compared treatment-related changes in calculated CHD risk among patients residing in PA and non-PA regions. Sensitivity analyses were conducted among men and women and those with and without diabetes., Results: Overall, 448 patients (31.6%) resided in the PA region and 969 patients (68.4%) resided in non-PA regions. The PMI approach was more effective in reducing calculated CHD risk versus UC in both PA (-37.1% versus -3.5%; P<0.001) and non-PA regions (-31.1% versus -4.2%; P<0.001); region interaction P=0.131. PA patients had slightly greater reductions in total cholesterol compared with non-PA patients. PA patients without diabetes had slightly greater reductions in CHD risk compared with non-PA patients. Treatment effects were similar in men and women and those with diabetes., Conclusion: The PMI approach was more effective in reducing calculated Framingham 10-year CHD risk compared with UC among men and women with and without diabetes residing in the PA and non-PA region.
- Published
- 2014
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