title: Guideline-adherent therapy in patients with cardiovascular diseases in Taiwan.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Jiann-Shing
authors.initials: JS
authors.lastname: Jeng
authors.affiliation: Division of Cardiology, Heart Center, Cheng-Hsin General Hospital, Taipei, Taiwan; School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Wei-Hsian
authors.initials: WH
authors.lastname: Yin
authors.affiliation: Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Chin-Chou
authors.initials: CC
authors.lastname: Huang
authors.affiliation: Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan.
authors.forename: Shao-Yuan
authors.initials: SY
authors.lastname: Chuang
authors.affiliation: Mackay Memorial Hospital, Mackay Medical College, New Taipei City, Taiwan.
authors.forename: Hung-I
authors.initials: HI
authors.lastname: Yeh
authors.affiliation: Office of Vice Superintendent on Medical Affairs, Tainan Municipal Hospital, Tainan, Taiwan.
authors.forename: Ching-Chang
authors.initials: CC
authors.lastname: Fang
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital and Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.affiliation: Cardiovascular Center, Taichung Veterans General Hospital, Taichung, Taiwan; Department of Medicine, Chung-Shan Medical University, Taichung, Taiwan.
authors.forename: Kuo-Yang
authors.initials: KY
authors.lastname: Wang
authors.affiliation: Department of Medical Imaging and Radiological Sciences, I-Shou University, Kaohsiung, Taiwan; Division of Cardiology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
authors.forename: Wei-Kung
authors.initials: WK
authors.lastname: Tseng
authors.affiliation: Department of Cardiology, Taipei Union Hospital, Taipei, Taiwan.
authors.forename: Lien-Chi
authors.initials: LC
authors.lastname: Huang
authors.affiliation: School of Medicine, Chung Shan Medical University, Taichung, Taiwan; Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung, Taiwan.
authors.forename: Kwo-Chang
authors.initials: KC
authors.lastname: Ueng
authors.affiliation: Second Department of Cardiology, Chang-Gung Memorial Hospital, New Taipei City, Taiwan.
authors.forename: I-Chang
authors.initials: IC
authors.lastname: Hsieh
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital and National Cheng Kung University, Tainan, Taiwan.
authors.forename: Yi-Heng
authors.initials: YH
authors.lastname: Li
authors.affiliation: Institute of Population Health Sciences, National Health Research Institute, Miaoli, Taiwan.
authors.forename: Wen-Harn
authors.initials: WH
authors.lastname: Pan
authors.affiliation: 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.
authors.forename: Chau-Chung
authors.initials: CC
authors.lastname: Wu
authors.affiliation: Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei, Taiwan; Institute of Pharmacology, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Jaw-Wen
authors.initials: JW
authors.lastname: Chen
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000453:epidemiology*; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000150:complications* / Q000453:epidemiology*; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000188:drug therapy; D008055:Lipids / Q000097:blood*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D012307:Risk Factors; D013624:Taiwan
chemical_list: D000959:Antihypertensive Agents; D008055:Lipids
keywords: adherence; cerebrovascular disease; coronary artery disease; hypertension; lipids