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Review: interventions that lower cholesterol concentrations or blood pressure in diabetic patients prevent cardiovascular disease

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 QUESTION: In patients with type 2 diabetes mellitus, do medications for intensive reduction of cholesterol and glucose concentrations and blood pressure prevent cardiovascular disease (CVD)?

Data sources

Studies were identified by searching Medline (1966 to 2000) and bibliographies of relevant studies and reviews.

Study selection

2 reviewers independently selected English-language randomised controlled trials (RCTs) that compared medications for intensive risk factor reduction with placebo or routine risk factor reduction in adults with type 2 diabetes; had ≥ 10 patients in each group; followed patients for ≥ 1 year; and reported on ≥ 1 of aggregate cardiac events, cardiovascular mortality, all cause mortality, myocardial infarction, and stroke. Exclusion criteria were non-pharmacological treatments, absence of prespecified outcomes, or comparing therapeutic agents rather than evaluating risk factor lowering.

Data extraction

Data were extracted on patient treatment, CVD history, diabetes duration, risk factor levels, and outcome events.

Main results

7 cholesterol …

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  • Sources of funding: Public Health National Research Service Award; American Diabetes Association; SmithKline Beecham; Health Resources and Service Administration.

  • For correspondence: Dr E S Huang, University of Chicago, Chicago, Illinois, USA. ehuang{at}