Diabetes Dateline
Spring/Summer 2008

Tight Cholesterol and Blood Pressure Control May Reverse Atherosclerosis in Adults with Diabetes

Aggressively lowering cholesterol and blood pressure levels below current targets in adults with type 2 diabetes could help prevent and possibly reverse hardening of the arteries, or atherosclerosis, according to new study results from the National Heart, Lung, and Blood Institute (NHLBI). Atherosclerosis, the number one cause of heart disease, can lead to heart attack, stroke, and death.

The 3-year Stop Atherosclerosis in Native Diabetics Study (SANDS) is the first study to compare two treatment targets for LDL, or bad, cholesterol and systolic blood pressure levels, key risk factors for heart and blood vessel disease, in people with diabetes. Sixty-five percent of diabetes deaths are related to cardiovascular causes.

About one-half of the 500 SANDS participants were asked to lower their LDL cholesterol and blood pressure to standard levels, while the other half aimed for more aggressive lowering. All participants were American Indians aged 40 or older who had diabetes and high blood pressure and elevated LDL cholesterol but no history of heart attack, stroke, or other evidence of cardiovascular disease.

“This study provides good news for adults with type 2 diabetes,” said NHLBI Director Elizabeth G. Nabel, M.D. “These patients are two to four times more likely than people without diabetes to die from heart disease. For the first time, we have evidence that aggressively lowering LDL cholesterol and blood pressure can actually reverse damage to the arteries in middle-aged adults with diabetes.”

The study was conducted at four clinical centers in southwestern Oklahoma, Phoenix, northeastern Arizona, and South Dakota. Results were published in the April 9 issue of the Journal of the American Medical Association.

The National Diabetes Information Clearinghouse has a fact sheet about diabetes, heart disease, and stroke at www.diabetes.niddk.nih.gov/dm/pubs/stroke.

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NIH Publication No. 08–4562
August 2008