Statins for All Adults With Diabetes?
Study: One-Third Less Diabetes-Linked Heart Disease With Cholesterol-Lowering Drugs
Jan 10, 2008 -- One-third fewer people with type 1 or type 2 diabetes would suffer heart attacks or strokes if they took cholesterol-lowering statin drugs, a U.K. study suggests.
Cardiovascular disease eventually kills two-thirds of people with diabetes, notes Colin Baigent, FFPH, FRCP, of England's Medical Research Council. High levels of "bad" LDL cholesterol play a major role.
Statin drugs -- sold in the U.S. as Crestor, Lescol XL, Lipitor, Mevacor, Pravachol, and Zocor -- lower LDL cholesterol. In people without diabetes, the drugs cut the risk of heart attack, stroke, and other cardiovascular diseases. But it hasn't been clear whether people with diabetes get as much benefit.
They do, Baigent and colleagues find. The researchers pooled data from 18,686 people with diabetes enrolled in 14 clinical trials of statins.
The result: People with diabetes, whether they are male or female, get just as much benefit from statins as anyone else. If 1,000 people with diabetes took statins for five years, 42 of them would avoid heart death, heart attack, or coronary revascularization (bypass or stenting).
"We are saying that, after middle age, most everybody with diabetes is a candidate for statin treatment -- and at a large enough dose to give them a substantial reduction in LDL cholesterol," Baigent tells WebMD. "That is quite important, because the size of the benefit depends on the size of the cholesterol reduction."
The American Heart Association says it's best to have an LDL cholesterol level of less than 100 mg/dL -- and calls LDL cholesterol levels of 100 to 129 mg/dL "near optimal/above optimal."
Baigent and colleagues calculate that for every 39 mg/dL drop in LDL cholesterol, people with diabetes cut their risk of major heart events by one-fifth. An average dose of statins cuts LDL cholesterol by 57 mg/dL, which would lower this risk by one-third.
But not everyone with diabetes has the same heart risk, argues Bernard M.Y. Cheung, MDBChir, PhD, FRCP, professor of clinical pharmacology and therapeutics at the University of Birmingham, England.