A STUDY OF PHARMACEUTICAL CARE IMPACT ON CARDIOVASCULAR RISK IN DIABETIC AND HYPERTENSIVE PATIENTS

Background: Coronary heart disease is the most common type of heart disease and is the major cause of death in India and a major cause of death worldwide ¹. It was thought previously to affect initially the higher income countries, but now CHD leads to more death in low- and middle-income countries such as India. Lifestyle modification is the main stay of treatment in preventing coronary heart disease.  The intervention by pharmacists through pharmaceutical care program can be useful in reducing coronary heart disease risk factors such as increased blood pressure, high blood glucose, and high lipid levels ^2-4.

Objective: To study the impact of pharmaceutical care intervention on general cardiovascular risk and to assess 10-year cardiovascular risk using Framingham scoring method.

Method:  Hypertensive and diabetic patients (N = 104) aged >45 years of age were enrolled.  Written informed consent was obtained from all the patients enrolled.  The pharmacist’s intervention included counseling on smoking cessation, alcohol reduction, increased compliance, weight reduction, increased exercise, and dietary changes. The parameters measured were blood pressure (both systolic and diastolic), total cholesterol, LDL cholesterol, HDL cholesterol, blood glucose, and body mass index (BMI).  Data were gathered at baseline (first visit); and subsequently at second review and third review.

Result:  The pharmaceutical care intervention brought a significant decrease in blood pressure (systolic blood pressure by 8.6% and diastolic blood pressure by 9%), blood glucose (fasting sugars by 14.5% and postprandial sugars by 17.9%), total cholesterol by 12.7%, LDL cholesterol by 13.7%, and HDL cholesterol increased by 12.5%.  BMI also showed a significant decrease by 5.2%.  The mean 10-year coronary heart disease risk decreased from 44.1% at first visit to 30.8 at last visit with a P value of 0.0001 which is very significant.

Conclusion:  The pharmaceutical care intervention proves to be a key in reducing the risk of developing cardiovascular disease in the next 10 years.