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ACCORD: Intensive BP, combined lipid therapies do not help adults with diabetes
Date:3/14/2010

gh the risks and benefits of various treatments to lower blood pressure."

The ACCORD lipid trial studied whether adding a fibrate to a statin to improve multiple blood lipids is more effective at lowering the risk of cardiovascular events than treatment with a statin alone. Both statins and fibrates are commonly used medications to treat abnormal levels of blood lipids. Statins lower LDL, or bad cholesterol, and are proven to lower cardiovascular disease risk in people with diabetes. Fibrates primarily lower fats in the blood known as triglycerides and raise HDL or good cholesterol. Fibrates are sometimes used in combination with statins. High triglycerides and low HDL levels are common in diabetes patients.

ACCORD is the first large clinical trial to compare the cardiovascular effects of a statin (simvastatin) and placebo, or inactive pill, to combination therapy of a statin (simvastatin) and a fibrate (fenofibrate) in high-risk adults with type 2 diabetes. The ACCORD lipid trial involved 5,518 participants. Researchers found that, overall, the combination therapy was safe, but it did not lower the risk of heart attack, stroke, or death from cardiovascular disease more than statins alone.

The researchers noted that participants who started the study with the lowest levels of HDL cholesterol plus the highest levels of triglycerides had lower rates of cardiovascular events if they received the combination therapy compared to similar participants who received only statin therapy. Although a similar effect has been seen in other studies, more research is needed on the effects on this subgroup, which comprised 17 percent of the ACCORD participants. The researchers also found that men may have benefitted from the combination lipid therapy whereas women on combination therapy appeared to have more cardiovascular problems than those on statins alone.

"Overall, the results of the ACCORD lipid trial do not support the use of combinatio
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NIH/National Heart, Lung and Blood Institute
Source:Eurekalert

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