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May 13, 2005

Individuals with Diabetes Should Lower Cholesterol with Statin Therapy

Individuals with diabetes should aggressively reduce their cholesterol levels and seek intensive statin therapy even if their levels of low-density lipoprotein (LDL) cholesterol is within the normal range, according to the American Diabetes Association.

The ADA recommendations state that diabetics who are older than 40 years of age whose total cholesterol exceeds 3.5 mmol/L (135 mg/dL) should be placed on statin therapy to achieve a 30% to 40% reduction in LDL level, regardless of their baseline LDL level and even if they do not have overt cardiovascular disease.

In the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis in Myocardial Infarction (PROVE-IT) study, treatment with atorvastatin 80 mg/day lowered LDL cholesterol levels to a median of 1.6 mmol/L (62 mg/dL) in diabetics and nondiabetics alike, compared to 2.5 mmol/L (97 mg/dL) with the standard pravastatin40-mg regimen.

Among patients taking atorvastatin, the hazard ratio for a cardiovascular event was 16% less than it was for patients on pravastatin after the mean follow-up period of 24 months, a significant difference (Cannon C. et al. N Engl J Med 2004;350:1495-1504).

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Posted by Diabetologica at May 13, 2005 12:47 PM