New Targets for LDL (“bad cholesterol”) for people with diabetes and coronary heart disease
In 2005, the American Diabetes Association added, as a treatment “option” for people with diabetes and cardiovascular disease, a target LDL of less than 70 mg/dl. This is a significant change from the old target of less than 100 mg/dl.
A new study, published in this month’s issue of Diabetes Care (June 2006) confirms the benefits of aiming for this more aggressive target. The study is a part of a larger study known as the “Treating to New Targets” study.
1501 patients with diabetes and coronary heart disease were randomized to receive either a low dose (10 mg per day) of atorvastatin (brand name Lipitor) or a high dose (80 mg per day). They were then followed until they experienced a major cardiovascular event (death from coronary heart disease, nonfatal heart attack, recovery from cardiac arrest, or stroke, fatal or nonfatal) or until the study ended. The median time to an event was about 5 years.
17.9% or 135 of the 753 people receiving the low dose of atorvastatin had a major cardiovascular event. This compares to 13.8% of the 748 people who took the higher dose experienced such an event. In addition, time to first major cardio vascular event or stroke was also significantly prolonged. There were no differences in the number of side effects experiences in the high vs low dose group.
This study adds to the growing body of evidence that suggests when it comes to LDL, lower is better. Although the authors point out further studies are needed to prove it definitively, I suspect we will see the major medical organizations, including the American Diabetes Association, coming out with stronger recommendations regarding attaining even lower targets of LDL (i.e., less than 70 mg/dl) for people with diabetes and cardiovascular disease. If you fall into this category, take some time to discuss these new findings with your doctor. When it comes to management of diabetes, it is important to “know your numbers and know your target.”
Note: This study was funded by Pfizer, the manufacturer of Lipitor.