Diabetes increases cardiovascular risk, and is recognised as a cardiovascular disease equivalent. Effective reduction of cardiovascular risk factors in diabetes patients is therefore vital. Several landmark clinical trials, including the Heart Protection Study, showed that statins reduce cardiovascular risk, even in patients with pretreatment low-density lipoprotein cholesterol (LDL-C) below 3 mmol/L. The Collaborative Atorvastatin Diabetes Study demonstrated that statin therapy significantly reduces LDL-C and major coronary events in patients with type 2 diabetes. Several studies have assessed which statins are most effective at reducing LDL-C. In patients with diabetes, rosuvastatin 10 mg and atorvastatin 10 mg bring 94% and 79% of patients, respectively, to European LDL-C goals. The benefits of more effective lipid lowering using high-dose statin therapy are being investigated in trials such as Treating to New Targets. Furthermore, studies indicate that combining a fibrate or niacin with a statin may offer more comprehensive lipid control in diabetes patients.
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