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Lower Lipid and Blood Pressure Goals May Help Heart

Intensive therapy led to regression of atherosclerosis

TUESDAY, April 8 (HealthDay News) -- Reducing low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure beyond traditional targets resulted in regression of atherosclerosis in individuals with type 2 diabetes, according to research published in the April 9 issue of the Journal of the American Medical Association.

Barbara V. Howard, Ph.D., of MedStar Research Institute in Hyattsville, Md., and colleagues compared the effect of aggressive lipid-lowering and anti-hypertensive treatment (LDL-C goal of 70 mg/dL or less; systolic blood pressure goal of 115 mm Hg) to standard treatment (LDL-C goal of 100 mg/dL; systolic blood pressure goal of 130 mm Hg) on progression of subclinical atherosclerosis, as measured by carotid artery intimal medial thickness, in 499 American Indian adults with type 2 diabetes.

In both groups, mean target LDL-C and blood pressure goals were reached and maintained, the researchers report. Compared with baseline values, carotid intimal medial thickness regressed in the aggressive treatment group, and progressed in the standard group. Furthermore, in the aggressive group, greater decreases in left ventricular mass were seen. However, rates of cardiovascular events did not differ between groups.

"Our data show significant retardation of atherosclerosis progression and regression of left ventricular hypertrophy through more intensive therapy, suggesting that if these targets were achieved and sustained longer, the incidence of cardiovascular disease events would be reduced," conclude the authors. "Further follow-up is needed to determine whether these improvements will result in lower long-term cardiovascular disease event rates and costs, and favorable risk-benefit outcomes."

Several of the study authors disclosed financial ties to the pharmaceutical industry. Study drugs were donated by First Horizon Pharmacy, Merck and Pfizer.

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