Aggressive Treatment of High LDL Levels and Hypertension in Patients with Diabetes

Three-year results from SANDS supply much-needed information but no definitive answer to the question of how low to set targets in primary prevention of CVD.

Controversy continues about how low to set target LDL and blood pressure levels for primary prevention of cardiovascular disease. The Stop Atherosclerosis in Native Diabetics Study (SANDS) addresses this issue in high-risk patients with type 2 diabetes and no history of CVD events. Investigators compared 3-year progression of subclinical atherosclerosis in 499 American Indian patients aged ≥40 years who were randomized either to aggressive treatment goals (≤70 mg/dL for LDL and ≤115 mm Hg for systolic blood pressure) or to standard-care goals (≤100 mg/dL for LDL and ≤130 mm Hg for SBP). The protocol algorithm for LDL reduction relied primarily on statins; the algorithm for blood-pressure reduction relied on ACE inhibitors or angiotensin-rec…

Reviewing Author

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

JoAnne M. Foody, MD

Disclosures

Consultant / Advisory boardAegerion; Amarin; Bristol-Myers Squibb; Janssen; Merck; Pfizer; Sanofi-Aventis; Boehringer Ingelheim

Leadership positions in professional societiesAmerican College of Cardiology, Cardiosmart (Co-chair)

Aggressive Treatment of High LDL Levels and Hypertension in Patients with Diabetes

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Reviewing Author