Two type 2 diabetes approaches don't help heart

April 9, 2010

In patients with type 2 diabetes at high risk for cardiovascular events, combination lipid therapy with fenofibrate and simvastatin does not reduce rate of cardiovascular events, compared with simvastatin alone.

N Engl J Med. [online] March 14, 2010. http://content.nejm.org/cgi/content/abstract/NEJMoa1001282v2. Accessed March 16, 2010.

In patients with type 2 diabetes at high risk for cardiovascular events, combination lipid therapy with fenofibrate and simvastatin does not reduce the rate of cardiovascular events compared with simvastatin alone, and intensive blood pressure control, compared to standard blood pressure control, also does not reduce the rate of adverse cardiovascular events, according to the results of two analyses of the Action to Control Cardiovascular Risk in Diabetes study. Researchers from Columbia University College of Physicians and Surgeons in New York randomized 5,518 patients with type 2 diabetes who were being treated with simvastatin to receive either fenofibrate or placebo. Compared to simvastatin monotherapy, the combination of fenofibrate and simvastatin did not reduce annual rates of adverse cardiovascular events over eight years, including death from cardiovascular causes, nonfatal stroke, or nonfatal myocardial infarction. Researchers at the Veterans Affairs Medical Center in Memphis, Tennessee, also evaluated intensive blood pressure control by randomizing 4,733 patients with type 2 diabetes to intensive blood pressure control or standard blood pressure control. Intensive blood pressure control did not reduce the rate of a composite outcome of death from cardiovascular events, nonfatal stroke, or nonfatal myocardial infarction.