Risk Factors, Preventive Practices, and Treatment Patterns Among Patients with Hypertension and Coronary Artery Disease at a Tertiary Care Hospital in Quetta: A Prospective Observational Study

Abstract

Background: Cardiovascular diseases, particularly hypertension and coronary artery disease (CAD), are major contributors to morbidity and mortality worldwide, with a growing burden in low- and middle-income countries due to clustering of modifiable risk factors such as smoking, obesity, diabetes mellitus, and dyslipidemia. Understanding local risk profiles and short-term response to integrated management is essential for improving prevention and clinical outcomes. Objective: To assess the prevalence of major risk factors, preventive practices, treatment patterns, and six-month clinical outcomes among patients with hypertension and/or CAD at a tertiary care hospital in Quetta, Pakistan. Methods: This prospective observational study enrolled 100 adults aged 30–75 years diagnosed with hypertension and/or CAD at Bolan Medical Complex Hospital, Quetta (January–December 2024). Baseline assessment included demographic data, cardiovascular risk factors, blood pressure, fasting glucose, lipid profile, ECG, and echocardiography. Patients received routine guideline-based pharmacologic therapy and lifestyle counseling, with reassessment at six months. Descriptive statistics were reported, and paired comparisons were used to evaluate pre–post changes. Results: The mean age was 54.3 ± 10.6 years, and 60% were male. Hypertension alone was present in 55%, CAD alone in 35%, and both conditions in 10%. The most prevalent risk factors were smoking (40%), diabetes mellitus (38%), obesity (35%), and dyslipidemia (32%). Significant improvements were observed at six months, including reductions in SBP (146 ± 18 to 134 ± 14 mmHg; p = 0.003) and LDL-C (130 ± 25 to 110 ± 22 mg/dL; p = 0.001), increases in HDL-C (42 ± 8 to 48 ± 9 mg/dL; p = 0.006), and improved ejection fraction (50 ± 7% to 55 ± 6%; p = 0.008). Conclusion: Patients with hypertension and/or CAD in this tertiary care cohort exhibited high prevalence of modifiable risk factors, and integrated pharmacologic therapy with lifestyle modification was associated with significant short-term improvements in blood pressure, lipid profile, and cardiac function, supporting the need for early screening and sustained multidisciplinary risk-factor control.