Chapter 18. Prevention of Hyperlipidaemia

  1. R. Williams3,
  2. W. Herman4,
  3. A.-L. Kinmonth6 and
  4. N. J. Wareham5
  1. Trevor J. Orchard1 and
  2. Linda Fried2

Published Online: 9 APR 2003

DOI: 10.1002/0470846585.ch18

The Evidence Base for Diabetes Care

The Evidence Base for Diabetes Care

How to Cite

Orchard, T. J. and Fried, L. (2003) Prevention of Hyperlipidaemia, in The Evidence Base for Diabetes Care (eds R. Williams, W. Herman, A.-L. Kinmonth and N. J. Wareham), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/0470846585.ch18

Editor Information

  1. 3

    Nuffield Institute for Health, University of Leeds, 71-75 Clarendon Road, Leeds LS2 9PL, UK

  2. 4

    Department of Internal Medicine and Epidemiology, 1500 East Medical Center Drive, 3920 Taubman Center, Box 0345, Ann Arbor, MI 48109, USA

  3. 5

    Department of Public Health and Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

  4. 6

    General Practice and Primary Care Research Unit, Dept. of Public Health & Primary Care, Institute of Public Health, University Forvie Site, Robinson Way, Cambridge CB2 2SR, UK

Author Information

  1. 1

    Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Diabetes and Lipid Research, 3512 Fifth Avenue, Pittsburgh, PA 15213, USA

  2. 2

    Renal Section, VA Pittsburgh Healthcare System, 4N167 University Drive, Pittsburgh, PA 15213, USA

Publication History

  1. Published Online: 9 APR 2003
  2. Published Print: 27 AUG 2002

ISBN Information

Print ISBN: 9780471988762

Online ISBN: 9780470846582

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Keywords:

  • coronary artery disease;
  • dyslipidemia;
  • cholesterol;
  • triglycerides;
  • nephropathy;
  • retinopathy;
  • neuropathy;
  • primary prevention;
  • secondary prevention;
  • lipid lowering

Summary

The prevention of hyperlipidemia is a critical component in the prevention of both macro- and microvascular complications of diabetes. Considerable data exist concerning the relationship of elevated LDL cholesterol to diabetes complications including cardiovascular disease and nephropathy, as well as the additional effects of diabetic dyslipidemia with multiple complications. The evidence base in terms of clinical trials is reviewed for lipid lowering in the prevention of both macro- and microvascular complications. In terms of the primary prevention of coronary heart disease, the strength of the evidence is modest owing to a paucity of studies; for secondary prevention, the strength of the recommendation is higher. Data for women and those with poorly controlled diabetes and/or traditional diabetic dyslipidemia are limited. The associations between lipid disorders and microvascular complications are less pronounced and few trials have investigated this: apart from an apparent benefit of lipid lowering to reduce hard exudates, there is little evidence, although a suggestion of benefit for proteinuria is apparent.