Statins may lower heart disease risk for diabetics

Statins - the best-selling class of cholesterol-fighting drugs - should be considered as standard therapy for all diabetics, apart from children and pregnant women, researchers said on Friday.

A group of British and Australian investigators said the largest study of its kind, involving a pooled analysis of clinical trials involving nearly 19 000 patients with diabetes, found there was a clear benefit in taking statins.

After five years, 42 fewer people with diabetes had major vascular events, such as heart attacks and strokes, for every 1 000 allocated statin therapy.

The findings are reassuring, particularly in the light of two other recent studies that found no statistically definitive benefit of statins in patients with diabetes. Diabetics are known to be at increased risk of cardiovascular disease.

Clears up uncertainty
Colin Baigent of the Clinical Trial Service Unit in Oxford, England, and one of the authors of the research published in The Lancet medical journal, said the latest data cleared up the uncertainty.

"Statins are clearly effective for a wide range of people with diabetes, irrespective of their absolute risk and irrespective of whether they have type 1 or type 2 (diabetes) or whether they are male or female," he said in a telephone interview.

"Generic statins are highly cost-effective, right down to an annual risk of about 1% per annum of a major vascular event, so it makes sense for statins to be used widely in most people with diabetes."

Cheaper generics available
Statins are the world's top-selling drugs and have been proved highly effective at cutting the risk of heart attack and stroke. They have made fortunes for drug companies like Pfizer Inc, which sells the market leader Lipitor, although they are now increasingly available as cheap generics.

Many diabetics already receive a statin because they are deemed at relatively high risk.

Baigent said the latest research should encourage doctors to use them more widely still.

"I think individual doctors will be influenced by this and, hopefully, also the guidelines bodies will consider it when they update their guidelines in due course," he said.

Diabetes, which is closely linked to obesity, is on the rise worldwide. At least 170 million people are estimated to have the disease and the number is predicted to at least double by 2030.

Bernard Cheung of the University of Birmingham, England, writing in a commentary in The Lancet, said the latest findings were reassuring but statins were not a panacea and doctors also needed to stress the importance of lifestyle changes, such as quitting smoking, healthy diet and regular exercise. – (Reuters Health)

January 2008