Lower LDL Cholesterol Below Recommended Levels Is Better

Lowering LDL (“bad”) cholesterol levels substantially below currently recommended levels significantly reduces the chances that people with diabetes and heart disease will suffer a stroke or heart attack, researchers report. Previously, a study showed that intensive cholesterol-lowering using the statin drug Lipitor at 80 milligrams per day rather than at 10 milligrams per day increased clinical benefits for patients with stable coronary disease, Dr. James Shepherd of the Royal Infirmary, Glasgow, UK and colleagues note in the June issue of Diabetes Care.

For the current analysis, the researchers looked at a subgroup of 1500 patients from this study who also had diabetes to see if they too benefited from a higher statin dose.

The subjects already had LDL cholesterol levels below 130 before starting the trial. Recently, the target LDL for such patients has been set at less than 100, the researchers explain.

They found that, after nearly five years, the average LDL cholesterol level was 99 in the low-dose group and 77 in the high-dose group.

Major cardiovascular events — that is, death, stroke, heart attack or cardiac arrest — occurred in 135 (17.9 percent) of the low-dose group and 103 (13.8 percent) of the high-dose group, amounting to a 25 percent reduction.

Pending a definitive clinical trial, the investigators conclude that the use of high-dose statins may be appropriate for patients with heart disease and diabetes, regardless of factors such as age and blood sugar control.

Diabetes Care, June 2006.

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