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

• Published in: Vascular health and risk management 2014-01, Vol.10 (default), p.145-156
• Main Authors: Cho, Eun Joo, Kim, Jae Hyung, Sutradhar, Santosh, Yunis, Carla, Westergaard, Mogens
• Format: Article
• Language: English
• Subjects: Adults; Aged; Amlodipine - adverse effects; Amlodipine - therapeutic use; anticholesteremic agents; antihypertensive agents; Antihypertensive Agents - adverse effects; Antihypertensive Agents - therapeutic use; Antihypertensives; Asia - epidemiology; Blood pressure; Calcium Channel Blockers - adverse effects; Calcium Channel Blockers - therapeutic use; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Cholesterol; clinical trial; Cultural differences; Demographic aspects; Diabetes; Diabetes Mellitus - epidemiology; Disease prevention; Drug Combinations; Dyslipidemias - diagnosis; Dyslipidemias - drug therapy; Dyslipidemias - epidemiology; Ethnicity; Europe; Female; Health risk assessment; Heptanoic Acids - adverse effects; Heptanoic Acids - therapeutic use; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypertension; Hypertension - diagnosis; Hypertension - drug therapy; Hypertension - epidemiology; Investigations; Latin America; Male; Medicine, Preventive; Methods; Middle Aged; Middle East; Original Research; Prevention; Preventive Health Services; Prospective Studies; Pyrroles - adverse effects; Pyrroles - therapeutic use; Risk Assessment; Risk Factors; Time Factors; Treatment Outcome
• ISSN: 1178-2048; 1176-6344; 1178-2048
• DOI: 10.2147/VHRM.S54586

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. 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. 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