title: Lifestyle changes for prehypertension with other cardiovascular risk factors: findings from Thailand.
abstract: OBJECTIVE
  To evaluate a model for community pharmacists to screen and recommend lifestyle changes for patients with prehypertension/hypertension and other elevated modifiable cardiovascular risk factors.
  
  
  METHODS
  Descriptive, exploratory, nonexperimental study.
  
  
  METHODS
  One accredited community pharmacy in Hat Yai, Thailand, between October 2008 and January 2009.
  
  
  METHODS
  Individuals 35 years or older without any previous diagnosis of hypertension and other cardiovascular disease.
  
  
  METHODS
  Measurement of blood pressure, blood glucose, total cholesterol, and body mass index; history taking for smoking and physical exercise; laboratory referral; assessment of readiness to adopt lifestyle changes; and provision of verbal advice and an education pamphlet on cardiovascular risk factors and recommended lifestyle modifications.
  
  
  METHODS
  Number of prehypertensive/hypertensive participants, patient return rate at 3-month follow-up, rate of laboratory referral uptake, confirmed glucose intolerance and dyslipidemia, and changes from baseline in blood pressure level.
  
  
  RESULTS
  263 of 400 people eligible for screening were found to have prehypertension or hypertension. Of these patients, 57% returned at 3-month follow-up. Mean (±SE) systolic (6.5 ± 0.89 mm Hg [95% CI 4.7-8.2], P < 0.001) and diastolic (2.2 ± 0.82 [0.54-3.77], P = 0.009) blood pressure were lowered. Compared with baseline (39.3%), the percentage of normotensive participants increased significantly at 3-month follow-up (51.8%; P < 0.001). The overall laboratory referral uptake was 36% (50 of 138). Glucose intolerance was confirmed in 2 of 21 participants. Of the 42 patients accepting laboratory confirmation, total and low-density lipoprotein cholesterol were confirmed to be above the normal range in 100% and 78.6%, respectively. Among these participants, those who returned at follow-up were rescreened for blood glucose and total cholesterol. Both values were found to be in the normal range. Although more participants reported lifestyle changes at 3 months, the smoking rate and amount of physical exercise were not changed.
  
  
  CONCLUSIONS
  Community pharmacists, through the use of point-of-care testing and referrals for laboratory testing, can detect patients who are at risk of developing or already have hypertension, diabetes, and/or dyslipidemia. Lifestyle advice from pharmacists can have a positive effect on these risk factors.
authors: Faculty of Pharmaceutical Sciences, Prince of Songkla University, Hat Yai, Thailand. pjurapor@yahoo.com
authors: Juraporn
authors: J
authors: Pongwecharak
authors: Tarakamon
authors: T
authors: Treeranurat
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003157:Community Pharmacy Services / Q000458:organization & administration*; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000628:therapy; D050171:Dyslipidemias / Q000175:diagnosis / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D008019:Life Style; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D010353:Patient Education as Topic / Q000379:methods; D010595:Pharmacists / Q000458:organization & administration; D019095:Point-of-Care Systems; D058246:Prehypertension / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D024382:Professional Role; D012307:Risk Factors; D013785:Thailand