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BP, Cholesterol, & Brain Health With Diabetes

Study found no effect, but longer-term trials may be needed to see a benefit, experts add


The study authors said there has been a lot of attention given to the possibility that better control of blood pressure and cholesterol might help people with diabetes avoid mental decline.

But although these types of treatments might be helpful for people with heart disease or stroke, the researchers said, the current study showed no overall reduction in the rate of mental decline linked to type 2 diabetes after intensive blood pressure and cholesterol control.

Other experts in diabetes and its relationship to heart health said more research might be necessary, however.

"Diabetes, along with its associated hypertension and cholesterol disorders, can significantly affect the small blood vessels in the brain," said Dr. Valentin Fuster, director of the division of cardiology at Mount Sinai Hospital in New York City. "However, diabetes, hypertension and cholesterol disorders take years to cause effects on the brain."

That means a study that followed patients for only about three years might simply be too short, said Fuster, who is also upcoming editor-in-chief of the Journal of the American College of Cardiology.

"Furthermore, the damage exerted in the brain by diabetes and its associated hypertension and cholesterol disorders may already be irreversible," he said. "If so, one could not expect significant changes with treatment."

Dr. Spyros Mezitis is an endocrinologist and diabetes specialist at Lenox Hill Hospital in New York City. He agreed with Fuster that the Wake Forest findings "may come as a surprise to many physicians who know there is decreased risk for stroke and heart attacks in diabetic patients with intensively controlled hypertension and high cholesterol."

"More studies need to be performed in this area of diabetic research," Mezitis said.

For his part, Marzo said the new study "supports present recommendations that physicians have their diabetic patients live a healthy lifestyle with diet and exercise, control blood pressure to a goal of 140/90 mmHg and treat cholesterol with a statin."

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