Low Adherence to Guideline for the Control of Major Cardiovascular Risk Factors in Diabetic Patients with Peripheral Arterial Disease: A Study in Northern Part of Thailand

Authors

  • Supapong Arworn Department of Surgery, Faculty of Medicine, Chiang Mai University
  • Saranat Orrapin Department of Surgery, Faculty of Medicine, Chiang Mai University
  • Natapong Kosachunhanun Department of Internal Medicine, Faculty of Medicine, Chiang Mai University
  • Kiran Sony Department of Internal Medicine, Chiangrai Prachanukroh Hospital
  • Nimit Inpankaew Department of Internal Medicine, Lamphun Hospital
  • Kittipan Rerkasem Department of Surgery, Faculty of Medicine, Chiang Mai University,Research Institute of Health Science, Chiang Mai University

Keywords:

blood pressure, diabetes, dyslipidemia, peripheral arterial disease, smoking

Abstract

Objective: The control of major cardiovascular risk factors is an important issue in the treatment of patients with
peripheral arterial diseases (PAD), and several large trials and many guidelines have stressed the importance of
detection and treatment of these risk factors. This is even critical in diabetic patients with PAD because such patients
carry higher risk of cardiovascular problem than non diabetic patients. However, it is not known to what extent this has
been applied to such patients. The objective of this study was to investigate the adequacy of risk factor management
in diabetic patients with PAD.
Methods: A cross-sectional study was conducted in 286 consecutive diabetic patients with PAD. A medical
history, medication history, and fasting venous blood sample were taken for each patient. The plasma concentrations
of cholesterol were determined. PAD was diagnosed when patients had low ankle brachial index (≤ 0.9). Then we
classified whether patients had good or poor control in each criteria according to the recommended guidelines between
PAD and non PAD.
Results: There were 2,247 diabetic patients, 874 (38.9) males and 1373 (61.1) females. Among them were 286
PAD patients. Diabetic patients with PAD had histories of cardiovascular events (angina pectoris, myocardial infarction,
unstable angina, stroke and transient ischemic attack) more than those without PAD. Apart from smoking, the
percentage of appropriate control of risk factors was around only 15-30% in PAD patients. When authors focused on
further details between non PAD, mild PAD and severe PAD, severe PAD had lower BMI and lower waist circumference
than those in other groups. Eighteen out of 286 PAD patients were still smoking.
Conclusion: Although the risk factors in vascular disease management are well understood and many guidelines
have been published, they do not seem to be well managed in diabetic patients with PAD.

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Published

2015-06-30

How to Cite

1.
Arworn S, Orrapin S, Kosachunhanun N, Sony K, Inpankaew N, Rerkasem K. Low Adherence to Guideline for the Control of Major Cardiovascular Risk Factors in Diabetic Patients with Peripheral Arterial Disease: A Study in Northern Part of Thailand. Thai J Surg [Internet]. 2015 Jun. 30 [cited 2024 Dec. 23];36(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/226195

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