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Intense Cholesterol, Blood Pressure Therapies Don't Help Type 2 Diabetics
Date:3/14/2010

rug Zocor (simvastatin) were randomly assigned to add fenofibrate or a placebo to their regimen.

Fenofibrate is used to increase HDL ("good") cholesterol levels and reduce triglyceride levels.

The double-strength approach did not result in any notable differences in the rate of fatal cardiovascular events or the incidence of non-fatal first heart attacks, non-fatal stroke or death from cardiovascular problems between the two treatment wings of the trial.

Further analyses did reveal that there might be a benefit for men and also for patients who started out with high triglyceride levels and low HDL cholesterol levels. But, for women, there was a "trend" toward actual harm.

The ACCORD blood pressure trial randomly assigned more than 4,700 men and women with type 2 diabetes to an intensive regimen intended to reduce systolic (the top number) blood pressure to less than 120 mm Hg, or to standard therapy designed to achieve systolic levels of 140 mm Hg.

Although participants in the intensive-therapy arm did achieve lower blood pressure levels, this did not translate into any substantial differences in the incidence of fatal or non-fatal cardiovascular events, such as heart attacks and stroke between the two groups, the team report.

There was a suggestion that taking blood pressure to lower levels might prevent the total number of stroke cases, but 89 people would need to be treated for five years to prevent one stroke, the study authors estimated.

And participants receiving intensive blood pressure therapy did experience more serious adverse events.

"Once systolic blood pressure starts to go above the 115 mark, the risk of heart attack and stroke starts to go up," Kopecky said.

However, previous research has shown dramatic reductions in heart problems in type 2 diabetics who combined medication with lifestyle changes such as exercise and eating five fruits and vegetables a day,
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