Reducing the Risk of Heart Attack and Stroke in Patients With Type 2 Diabetes

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Reduction in cardiovascular events with atorvastatin in 2,532 patients with type 2 diabetes, by P.S. Sever and colleagues. Diabetes Care 28:1151-1157, 2005.

What is the problem and what is known about it so far?

Type 2 diabetes often leads to cardiovascular (heart) disease, which causes heart attacks and strokes. More than 75% of people with diabetes die from heart disease. People who have diabetes, high blood pressure, and high cholesterol (a waxy, fat-like substance that builds up in the blood vessels) are more likely to have a heart attack or stroke.

Why did the researchers do this particular study?

Few studies have looked at the effect of drugs to lower cholesterol in patients with diabetes who do not have heart disease. The researchers wanted to see if there was any benefit to lowering cholesterol in patients who have diabetes and high blood pressure but don't have high cholesterol or heart disease.

Who was studied?

More than 10,000 men and women from the Anglo-Scandinavian Outcomes Trial (www.ascotstudy.org) were studied; 2,532 of the patients had type 2 diabetes. All of the patients had high blood pressure and were thought to have higher-than-normal chances of getting heart disease.

How was the study done?

The patients were put in one of two groups: one that took a drug to lower cholesterol (atorvastatin) and one that took a placebo (a pill that has no effect). The patients were also treated for high blood pressure. Over a 3-year time span, researchers checked the patients to see if they had any heart problems.

What did the researchers find?

Over the 3 years, researchers saw that total and LDL cholesterol (the "bad" cholesterol) was lower in the patients who took a cholesterol drug than in the patients who took placebo. The researchers found that the cholesterol drug lowered the chance of having a heart attack or stroke in both patients with and without diabetes.

What were the limitations of the study?

Some patients in this study were taking other medications, and this could have affected the outcomes of the study.

What are the implications of the study?

People with diabetes have a higher chance of having a heart attack or stroke than people who don't have diabetes. Based on the results of this study, the researchers believe that doctors should consider prescribing cholesterol drugs to patients with type 2 diabetes and high blood pressure in order to lower their risk of having a heart attack and stroke.

FOR MORE INFORMATION

Drug Therapy for High Cholesterol

Treating High Blood Pressure in People with Diabetes

101 Tips for Staying Healthy, 2nd ed., by David S. Schade and Associates (Alexandria, Va., ADA, 1999)

Adherence to statin therapy and LDL goal attainment by patients with diabetes and dyslipidemia, by E.S. Parris and colleagues. Diabetes Care 28:595-599, 2005.