From The NEJM: To Reduce Diabetes Heart Risks, Diet/Exercise May Beat Drugs

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Four new studies published in this week's New England Journal of Medicine bring nothing but disappointing news for diabetics who rely on drugs to lower their risk of heart attacks and strokes.


An estimated 24 million Americans have diabetes, which is the seventh leading cause of death in the United States. Adults with type 2 diabetes are two to four times more likely than adults without diabetes to die from heart disease, and 65 percent of deaths in people with diabetes are from cardiovascular causes.



One study found that using antihypertensives to lower systolic (the top number) blood pressure below a healthful measurement of 120 mm Hg does nothing to lower a diabetic's risk of heart complications; another found no benefit to adding a drug to raise HDL "good" cholesterol levels in diabetics who were already taking a statin to lower the bad kind. N heart benefits were associated with two drugs given to lower high blood sugar levels, according to the two other studies.

One key study is known as ACCORD - one of the largest studies ever conducted in adults with type 2 diabetes who were at especially high risk of cardiovascular events, such as heart attacks, stroke, or death from cardiovascular disease.

The multicenter clinical trial tested three potential strategies to lower the risk of major cardiovascular events: intensive control of blood sugar, intensive control of blood pressure, and treatment of multiple blood lipids. The lipids targeted for intensive treatment were high density lipoprotein (HDL) cholesterol and triglycerides, in addition to standard therapy of lowering low density lipoprotein (LDL) cholesterol. Source.


For a good explanation of the result, go to NEJM and take a look at this report: http://www.medpagetoday.com/MeetingCoverage/ACC/19000