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NEW YORK (Reuters Health) - People with diabetes, coronary heart disease, and chronic kidney disease benefit from having their cholesterol levels lowered aggressively with high doses of Lipitor, according to a Mayo Clinic report.
"Patients with both diabetes and chronic kidney disease are at much greater risk of major cardiovascular events and death than those with either condition alone," Dr. James Shepherd, of the University of Glasgow, UK, and colleagues explain in the Mayo Clinic Proceedings journal.
Shepherd's team examined the effect of intensive cholesterol lowering with high-dose versus low-dose Lipitor (also known as atorvastatin) in patients with coronary artery disease and type 2 diabetes, with or without chronic kidney disease.
Among the patients with kidney disease, a heart-related event occurred in 14 percent of those given high-dose atorvastatin and in 21 percent on low-dose atorvastatin during almost 5 years of follow-up.
This difference was "substantial," the team notes. They calculate that one major cardiovascular event was prevented for every 14 patients who were treated with high-dose rather than low-dose Lipitor.
In patients without kidney disease, there was no significant difference in event rates with high versus low doses of atorvastatin (13 percent versus 14 percent) the investigators report.
Both doses of atorvastatin were well tolerated.
The researchers recommend that intensive cholesterol-lowering should be started for these patients early in the course of chronic kidney disease.
SOURCE: Mayo Clinic Proceedings, August 2008.
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Date last updated: 05 September 2008 |