How Low Should We Go (with BP and Cholesterol in Diabetic Patients)?

Several studies in patients with diabetes and known cardiovascular disease (CVD) have suggested that lower is better for both LDL cholesterol (LDL-C) levels and systolic blood pressure (SBP). In an NIH-funded study, researchers assessed whether lower-risk people with diabetes and without known heart disease also benefit from lower targets.

A total of 499 adult Native Americans with type 2 diabetes but without known CVD were randomized to aggressive (LDL-C level, ≤70 mg/dL; SBP, ≤115 mm Hg) or standard treatment targets (LDL-C level, ≤100 mg/dL; SBP, 130 mm Hg), using stepwise drug treatment approaches and lifestyle modifications. Carotid intima–media thickness (IMT) and left ventricular function were assessed at baseline, 18 months, and 36 m…