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Do Lipid-Lowering Agents Provide a Greater Reduction in Cardiovascular Events among Patients with Diabetes?
- Ned Calonge, MD, MPH; and
- Diana Petitti, MD, MPH
- From the Colorado Department of Public Health and Environment, Denver, CO 80246, and Keck School of Medicine, University of Southern California, Los Angeles, CA 90089.
IN RESPONSE:
In making its recommendation on screening for type 2 diabetes, the USPSTF considered interventions, including lipid-lowering agents, for effects on such health outcomes as cardiovascular events. In reviewing the evidence on lipid-lowering agents, the USPSTF found that persons with diabetes do not seem to benefit to a greater extent than those without for the primary prevention of cardiovascular events, whether considering absolute or relative risk reduction. For example, in the Heart Protection Study, the absolute reduction in coronary events for participants receiving simvastatin versus placebo was similar in those with and without diabetes: 3.2% and 3.0%, respectively (calculated from data in the Heart Protection Study) (1). Therefore, the evidence does not support screening for type 2 diabetes on the basis of lipid status. However, the USPSTF encourages clinicians to perform a global cardiovascular disease risk assessment to determine a person's 10-year cardiovascular disease risk (2) and to screen for type 2 diabetes if knowledge of diabetes status would change management, including the management of hypertension or the use of lipid-lowering agents and aspirin.
Ned Calonge, MD, MPH
Colorado Department of Public Health and Environment
Denver, CO 80246
Diana Petitti, MD, MPH
Keck School of Medicine, University of Southern California
Los Angeles, CA 90089
Article and Author Information
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Potential Financial Conflicts of Interest: None disclosed.
