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Impact of atherosclerosis detection by carotid ultrasound on physician behavior and risk-factor management in asymptomatic hypertensive subjects.

 Sung Jin Hong  ;  Hyuk Jae Chang  ;  Kijun Song  ;  Geu Ru Hong  ;  Seung Woo Park  ;  Hyun Jae Kang  ;  Eung Ju Kim  ;  Dong Soo Kim  ;  Myung Ho Jeong 
 CLINICAL CARDIOLOGY, Vol.37(2) : 91-96, 2014 
Journal Title
Issue Date
Aged ; Asymptomatic Diseases ; Attitude of Health Personnel* ; Biomarkers/blood ; Carotid Arteries/diagnostic imaging* ; Carotid Artery Diseases/blood ; Carotid Artery Diseases/diagnostic imaging ; Carotid Artery Diseases/drug therapy* ; Carotid Artery Diseases/epidemiology ; Carotid Intima-Media Thickness* ; Cholesterol, LDL/blood ; Female ; Health Knowledge, Attitudes, Practice* ; Humans ; Hypertension/diagnosis ; Hypertension/drug therapy* ; Hypertension/epidemiology ; Hypolipidemic Agents/therapeutic use* ; Male ; Middle Aged ; Physicians/psychology* ; Practice Patterns, Physicians'* ; Predictive Value of Tests ; Prospective Studies ; Republic of Korea/epidemiology ; Risk Assessment ; Risk Factors
BACKGROUND: There are limited data regarding the impact of atherosclerosis detection by carotid ultrasound (CUS) on physician prevention efforts and risk-factor management for cardiovascular disease.
HYPOTHESIS: Atherosclerosis detection by CUS in asymptomatic hypertensive patients would lead to physician prevention efforts, including target low-density lipoprotein cholesterol (LDL-C) level and prescription. Also, it may improve risk-factor management.
METHODS: A total of 347 asymptomatic hypertensive subjects (age 61 ± 8 years, 189 men) were prospectively recruited from 22 hospitals. Prior to CUS, physicians were surveyed regarding target LDL-C level. After CUS, patients were classified into positive CUS (n = 182) and negative CUS (n = 165) groups based on CUS results. Physicians were resurveyed to assess whether the initial target LDL-C goals were changed. At 6 months, cardiovascular risk-factor modification status was reassessed.
RESULTS: The proportion of lowered target LDL-C levels was significantly larger in the positive CUS group than in the negative CUS group (52% vs 23%, P < 0.001). These results were observed even in subjects who had low and moderate risk according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Lipid-lowering agents were similarly added or switched to another class in both groups (7% in the positive CUS group vs 11% in the negative CUS group, P = 0.153). LDL-C was significantly decreased in the positive CUS group (Δ = -24 ± 38 mg/dL, P < 0.001), whereas it was not significantly decreased in the negative CUS group (Δ = -6 ± 31 mg/dL, P = 0.105).
CONCLUSIONS: Atherosclerosis detection by CUS lowered physicians' target LDL-C level and improved cardiovascular risk management in terms of LDL-C reduction.
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1. College of Medicine (의과대학) > Dept. of Biomedical Systems Informatics (의생명시스템정보학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Song, Ki Jun(송기준) ORCID logo https://orcid.org/0000-0003-2505-4112
Chang, Hyuk-Jae(장혁재) ORCID logo https://orcid.org/0000-0002-6139-7545
Hong, Geu Ru(홍그루) ORCID logo https://orcid.org/0000-0003-4981-3304
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
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