Chapter 13. Does Treating Hyperlipidaemia with Medication Prevent Complications?

  1. William H. Herman2,
  2. Ann Louise Kinmonth3,
  3. Nicholas J. Wareham4 and
  4. Rhys Williams5
  1. Helen M. Colhoun

Published Online: 12 JAN 2010

DOI: 10.1002/9780470682807.ch13

The Evidence Base for Diabetes Care, Second Edition

The Evidence Base for Diabetes Care, Second Edition

How to Cite

Colhoun, H. M. (2010) Does Treating Hyperlipidaemia with Medication Prevent Complications?, in The Evidence Base for Diabetes Care, Second Edition (eds W. H. Herman, A. L. Kinmonth, N. J. Wareham and R. Williams), John Wiley & Sons, Ltd, Chichester, UK. doi: 10.1002/9780470682807.ch13

Editor Information

  1. 2

    Department of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, MI, USA

  2. 3

    General Practice and Primary Care Research Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK

  3. 4

    MRC Epidemiology Unit, Institute of Metabolic Science, Addenbrooke's Hospital, Cambridge, UK

  4. 5

    School of Medicine, Swansea University, Swansea, UK

Author Information

  1. Department of Genetic Epidemiology, University College Dublin Belfield, Dublin, Ireland

Publication History

  1. Published Online: 12 JAN 2010
  2. Published Print: 19 FEB 2010

ISBN Information

Print ISBN: 9780470032749

Online ISBN: 9780470682807

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Keywords:

  • hyperlipidaemia;
  • low-density lipoprotein cholesterol;
  • triglycerides;
  • statins;
  • fibrates;
  • niacin;
  • cardiovascular disease

Summary

There is now good evidence supporting the efficacy and safety of currently available drugs for lowering low-density lipoprotein cholesterol (LDL-C) in the prevention of cardiovascular disease (CVD) in patients with diabetes, particularly with statin therapy. Almost all patients with type 2 diabetes who can tolerate the medication warrant such therapy. The extent to which lowering triglycerides and raising HDL-C with currently available drugs reduces CVD risk remains less clear. Trials of fibrates in patients with diabetes and established CVD have given conflicting results. In patients without CVD, lowering LDL-C with a statin seems more efficacious than focusing on triglycerides and HDL-C with a fibrate. The effect of sole therapy with niacin on CVD risk in diabetes is untested. Trials are under way to provide an evidence base for some important outstanding questions, in particular the role of combination therapy (statin plus fibrate, statin plus niacin, statin plus ezetimibe) in patients at goal for LDL-C and the efficacy of lipid lowering in advanced renal disease