Navigation Links
Aggressive Cholesterol, Blood Pressure Treatment Shows Some Benefit

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 in the carotid artery," said study leader Dr. Mary J. Roman, a professor of medicine at Weill Cornell Medical College.

To achieve the LDL cholesterol target, a blood level of 70, "I would still consider using ezetimibe [a second-line, cholesterol-lowering drug] in people who cannot tolerate statins and people who cannot achieve the target with maximum doses of statins or other medication," Roman said.

And while the incidence of side effects was higher in those treated aggressively for high blood pressure, Roman said, "aiming for that target has a beneficial effect. It is always easy to back off and not be as aggressive."

There was some disagreement on aggressive treatment of high blood pressure from Dr. Eric D. Peterson, a professor of medicine at Duke University, and author of an accompanying editorial.

"It would seem, based on what we have here, hard to justify ultraintensive hypertension reduction when we haven't shown benefit from a clinical viewpoint," Peterson said.

But with LDL cholesterol, "many arguments can be made for aggressive treatment in diabetic populations," he said.

The side effects of aggressive LDL cholesterol-lowering treatment are "minimal," Peterson said, and the addition of ezetimibe (Zetia) to statin treatment in some cases "seems to be reasonable."

"But ezetimibe has been a second-line agent," he said. "I would never use it as a first-line agent."

Ezetimibe has also been the subject of controversy in recent months as trials have started to show that adding the drug to statin treatment produces no benefit in reducing plaque build-up in blood vessels.

More information

The links between diabetes and heart disease are outlined by the American Diabetes Association.

SOURCES: Barbara V. Howard, Ph.D., senior scientist, MedStar Research Institute, Hyattsville, Md.; Mary J. Roman, M.D., professor, medicine, Weill Cornell Medical College, New York City; Eric D. Peterson, M.D., professor, medicine, Duke University, Durham, N.C.; April 9, 2008, Journal of the American Medical Association

Copyright©2008 ScoutNews,LLC.
All rights reserved  

Related medicine news :

1. Frequent Prostate Screens Fail to Improve Aggressive Cancer Diagnoses
2. Coalition for Pulmonary Fibrosis Launches Aggressive Ad Campaign Directed at United States Congress
3. AWT Management Announce Aggressive Growth and Acquisition Strategy
4. Novel strategy under study for aggressive leukemia
5. Prostate cancer more likely to return in blacks than whites, but the disease is not more aggressive
6. Mayo Clinic tests novel vaccine for aggressive brain tumors
7. Aggressively Treating Cardiac Risk Factors May Reverse Ischemia
8. Breast cancer is more aggressive in African-American women
9. Gene Variant Tied to More Aggressive Prostate Cancer
10. Study finds gene linked to aggressive prostate cancer
11. Even tiny breast tumors can be aggressive and may require maximum therapy
Post Your Comments:
Related Image:
Aggressive Cholesterol, Blood Pressure Treatment Shows Some Benefit
(Date:6/25/2016)... ... 25, 2016 , ... Experts from the American Institutes for ... Meeting June 26-28, 2016, at the Hynes Convention Center in Boston. , AIR ... care planning, healthcare costs and patient and family engagement. , AIR researchers will ...
(Date:6/25/2016)... ... , ... "With 30 hand-drawn hand gesture animations, FCPX users can easily customize ... Pixel Film Studios. , ProHand Cartoon’s package transforms over 1,300 hand-drawn pictures into ... Simply select a ProHand generator and drag it above media or text in the ...
(Date:6/25/2016)... ... June 25, 2016 , ... Dr. Calvin ... injury. Recently, he has implemented orthobiologic procedures as a method for treating his ... of the first doctors to perform the treatment. Orthobiologics are substances that orthopaedic ...
(Date:6/24/2016)... ... June 24, 2016 , ... A recent article published June ... with. The article goes on to state that individuals are now more comfortable seeking ... common operations such as calf and cheek reduction. The Los Angeles area medical group, ...
(Date:6/24/2016)... ... 2016 , ... Marcy was in a crisis. Her son James, eight, was out of control. ... and physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. ... rocks at my other children and say he was going to kill them. If ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... CHAPEL HILL, N.C. , June 24, 2016 ... in healthcare decisions and regulators/payers have placed more ... this new environment, patient support programs in the ... support for patients, medications. Consequently, pharmaceutical companies are ... to ensure they are providing products and services ...
(Date:6/24/2016)... June 24, 2016  Global Blood Therapeutics, Inc. (GBT) ... developing novel therapeutics for the treatment of grievous ... the closing of its previously announced underwritten public ... the public offering price of $18.75 per share. ... offered by GBT. GBT estimates net proceeds from ...
(Date:6/24/2016)... , June 24, 2016 ... Markets has announced the addition of the " ... offering. This ... and provides an updated review, including its applications in ... the total market, which includes three main industries: pharmaceutical ...
Breaking Medicine Technology: