Tags

Type your tag names separated by a space and hit enter

What is the most effective strategy for managing diabetic dyslipidaemia?
Atheroscler Suppl. 2005 Sep; 6(3):21-7.AS

Abstract

The dyslipidaemic profile of diabetes greatly contributes to the increased cardiovascular risk associated with the disorder, and evidence from many intervention trials using statins, fibrates, nicotinic acid or a nicotinic acid-statin combination, indicates the substantial cardiovascular risk reduction to be gained from lipid modification. Several large statin trials have demonstrated the efficacy of cholesterol-lowering in individuals with coronary heart disease and raised low-density lipoprotein-cholesterol (LDL-C) (>or=130 mg/dL; >or=3.4 mmol/L), but for the 40% of patients whose LDL-C is within recommended limits, many of whom have low high-density lipoprotein-cholesterol (HDL-C), an alternative strategy is necessary if excess risk is to be minimized. The veterans affairs high-density lipoprotein cholesterol intervention trial (VA-HIT) proved the efficacy of the fibric acid derivative, gemfibrozil, to elevate HDL-C and reduce triglycerides, with a resulting 22% relative risk reduction for cardiovascular death or non-fatal myocardial infarction, and even greater reductions in individuals with insulin resistance and diabetes. Increased HDL-C was independently predictive of reduction in coronary heart disease. In the Coronary Drug Project, individuals with diabetes or insulin resistance derived as much as 70% cardiovascular risk reduction from the HDL-C elevations achieved with nicotinic acid therapy. The effects of lowering LDL-C and raising HDL-C are additive and predictive of total cardiovascular event reduction, and by using statin-nicotinic acid combination therapy, cardiovascular risk reductions as great as 90% are possible. Such combination strategies offer patients the greatest opportunity for improved cardiovascular health and are likely to become the treatment strategy of the future.

Authors+Show Affiliations

University of Texas Health Science Center, Department of Medicine/Endocrinology, San Antonio, TX 78284-7877, USA. charles.reasner@uhs-sa.com

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

16054442

Citation

Reasner, Charles A.. "What Is the Most Effective Strategy for Managing Diabetic Dyslipidaemia?" Atherosclerosis. Supplements, vol. 6, no. 3, 2005, pp. 21-7.
Reasner CA. What is the most effective strategy for managing diabetic dyslipidaemia? Atheroscler Suppl. 2005;6(3):21-7.
Reasner, C. A. (2005). What is the most effective strategy for managing diabetic dyslipidaemia? Atherosclerosis. Supplements, 6(3), 21-7.
Reasner CA. What Is the Most Effective Strategy for Managing Diabetic Dyslipidaemia. Atheroscler Suppl. 2005;6(3):21-7. PubMed PMID: 16054442.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - What is the most effective strategy for managing diabetic dyslipidaemia? A1 - Reasner,Charles A, PY - 2005/8/2/pubmed PY - 2005/12/21/medline PY - 2005/8/2/entrez SP - 21 EP - 7 JF - Atherosclerosis. Supplements JO - Atheroscler Suppl VL - 6 IS - 3 N2 - The dyslipidaemic profile of diabetes greatly contributes to the increased cardiovascular risk associated with the disorder, and evidence from many intervention trials using statins, fibrates, nicotinic acid or a nicotinic acid-statin combination, indicates the substantial cardiovascular risk reduction to be gained from lipid modification. Several large statin trials have demonstrated the efficacy of cholesterol-lowering in individuals with coronary heart disease and raised low-density lipoprotein-cholesterol (LDL-C) (>or=130 mg/dL; >or=3.4 mmol/L), but for the 40% of patients whose LDL-C is within recommended limits, many of whom have low high-density lipoprotein-cholesterol (HDL-C), an alternative strategy is necessary if excess risk is to be minimized. The veterans affairs high-density lipoprotein cholesterol intervention trial (VA-HIT) proved the efficacy of the fibric acid derivative, gemfibrozil, to elevate HDL-C and reduce triglycerides, with a resulting 22% relative risk reduction for cardiovascular death or non-fatal myocardial infarction, and even greater reductions in individuals with insulin resistance and diabetes. Increased HDL-C was independently predictive of reduction in coronary heart disease. In the Coronary Drug Project, individuals with diabetes or insulin resistance derived as much as 70% cardiovascular risk reduction from the HDL-C elevations achieved with nicotinic acid therapy. The effects of lowering LDL-C and raising HDL-C are additive and predictive of total cardiovascular event reduction, and by using statin-nicotinic acid combination therapy, cardiovascular risk reductions as great as 90% are possible. Such combination strategies offer patients the greatest opportunity for improved cardiovascular health and are likely to become the treatment strategy of the future. SN - 1567-5688 UR - https://www.unboundmedicine.com/medline/citation/16054442/What_is_the_most_effective_strategy_for_managing_diabetic_dyslipidaemia L2 - https://linkinghub.elsevier.com/retrieve/pii/S1567-5688(05)00047-4 DB - PRIME DP - Unbound Medicine ER -