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Aggressive Cholesterol, Blood Pressure Treatment Shows Some Benefit
Date:4/8/2008

But jury still out on whether it makes difference in high-risk groups, study finds

TUESDAY, April 8 (HealthDay News) -- A new study that weighed whether aggressively lowering cholesterol levels and blood pressure in people at high risk of heart disease is worth the effort did not produce a definitive answer to the question.

The research, which involved 499 American Indians with diabetes, found the strategy led to some improvements without producing dangerous side effects, said Barbara V. Howard, lead author of the report in the April 9 issue of the Journal of the American Medical Association.

"This is the first trial that really tested targeting," said Howard, a senior scientist with the Medstar Research Institute in Maryland. "Until now, clinical trials have meant taking a drug and escalating the dose and comparing the reduction in heart disease. Our goal was to target people at high risk and test lower targets for both risk factors hypertension and LDL cholesterol. What we showed is that you can reach those lower targets safely."

The improvement seen was a reduction in the thickening of the walls of the carotid artery, the main artery to the brain. However, no difference in the rate of adverse events was seen between those who had the most aggressive treatment and those who had standard treatment. "But there have been no trials where the carotid measurements did not correlate eventually with what happened in the endpoints," Howard noted.

The main conclusion of the trial is that "we see improvement with lower targets, but we need longer studies," Howard noted.

So, what should be done with the millions of Americans at increased coronary risk because, like the people in the trial, they have diabetes?

"What it says is that more aggressive targets than have been traditionally recommended can be achieved, can be achieved safely, and are associated with regression of plaque build-up
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