More good cholesterol, lower pressure do not help diabetics: study
Posted: 15 March 2010 1147 hrs

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ATLANTA - Increasing the amount of good cholesterol in the body and lowering blood pressure do not reduce the risk of heart disease among people suffering from diabetes, according to a new study unveiled Sunday.

The results from the landmark Action to Control Cardiovascular Risk in Diabetes (ACCORD) clinical trial were presented here at the 59th annual conference of the American College of Cardiology.

The study was sponsored by the National Institutes of Health.

Researchers from 77 medical centers in the United States and Canada studied 10,251 participants between the ages of 40 and 79 who had type 2 diabetes for an average of 10 years.

When they joined the study, all participants were at especially high risk of cardiovascular disease because they had pre-existing conditions, evidence of subclinical cardiovascular disease, or at least two cardiovascular disease risk factors in addition to diabetes.

Researchers divided 4,733 of the participants with elevated blood pressure into two groups to receive, respectively, intensive treatment with blood pressure medication and standard treatment.

After an average follow-up of about five years, researchers found no significant differences between the intensive group and the standard group in rates of a combined endpoint including nonfatal heart attack, nonfatal stroke, or cardiovascular death, the study concluded.

There were 208 cardiovascular events in the intensive group and 237 events in the standard group.

Scientists also studied whether adding a fibrate to a statin to improve multiple blood lipids is more effective at lowering the risk of cardiovascular events than treatment with a statin alone.

Both statins and fibrates are commonly used medications to treat abnormal levels of bad cholesterol in the blood.

These trials involved 5,518 participants, but researchers found that, overall, it did not lower the risk of heart attack, stroke, or death from cardiovascular disease more than statins alone.

"Type 2 diabetes affects approximately 200 millions people around the world and increases the risk for cardiovascular disease by two to four times," commented Doctor Henry Ginsberg, a professor of medicine at Columbia University College of Physicians and Surgeons.

"The findings of the ACCORD lipid trial provide physicians with important new information regarding the treatment of a common lipid abnormality affecting many of their patients with type 2 diabetes," he said.

"Overall the results of the ACCORD lipid trial do not support use of combination therapy with fenofibrate and simvastatin to reduce cardiovascular disease in high-risk patients with type 2 diabetes," Ginsberg concluded.

- AFP/ar