July 22, 2014
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Diabetes

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Study: Cholesterol reduction equals lower heart risk for diabetes patients

Current guidelines from the US National Cholesterol Education Program recommend that people with diabetes keep their LDL-cholesterol levels below 2.56 mmol/L (100 mg/dL), with the optional goal of lower than 1.79 mmol/L (70 mg/dL). These levels are below those of the general population because people with diabetes carry a higher risk of dying from cardiovascular disease. But a study suggests lowering cholesterol levels below the guidelines could help reduce that risk.

Researchers at the University of Glasgow Medical School in Scotland compared the effects of lowering cholesterol to the two target levels. The study involved 1,500 patients between the ages of 35 and 75 who had diabetes and heart disease and had LDL cholesterol levels below 3.34 mmol/L (130 mg/dL). All of the participants started the trial with 8 weeks of 10 mg of atorvastatin in order to bring their LDL below 3.34 mmol/L. After 8 weeks, the participants were randomly assigned to either receive 80 mg of atorvastatin per day or to continue with 10 mg of the cholesterol-lowering medication.

After an average follow-up of nearly 5 years, participants on the 80 mg dosage of atorvastatin reduced their LDL levels to about 1.97 mmol/L (77 mg/dL), while those on the 10 mg dosage had average cholesterol levels of about 2.53 mmol/L (99 mg/dL). People in the group that saw the greater reductions in LDL cholesterol experienced 25% fewer cardiovascular events, including heart attacks, fatal or non-fatal strokes, and cardiac arrest.

"These data are the first to demonstrate the cardiovascular benefits of lowering LDL-C beyond recommended guidelines," said Dr. James Shepherd, one of the researchers involved in the study.

"If you are aggressive in your intervention with a statin, you will get a significant reduction, 25% in this trial, of major cardiovascular events when compared with a more conventional statin intervention."

Statins are a class of cholesterol-lowering drugs that also includes pravastatin, rosuvastatin, and simvastatin. These medications work by blocking an enzyme that creates cholesterol in the body.

While Shepherd's study used atorvastatin, when asked by an audience member whether he would recommend any particular member of this class to reduce the risk, he said: "Aggressive lipid-lowering with any statin would suit me fine." The study was presented at the annual meeting of the American Diabetes Association.


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