A new report in The American Journal of Cardiology has confirmed that increasing levels of high-density lipoproteins, better known as HDL or good cholesterol, can reduce the risk of having a heart attack and stroke among patients with diabetes.
The observational study, which was undertaken by the Kaiser Permanente Center for Health Research in Portland, Oregon, examined the medical records of more than 30,000 patients with diabetes and also found that patients whose HDL levels decreased had more heart attacks and strokes.
Heart UK expert, Dr Dermot Neely, said: “This large study confirms the importance of considering HDL-cholesterol in patients with diabetes at high cardiovascular risk, even those with apparently good control of LDL-cholesterol.
“At present measurement of the good HDL-cholesterol is mainly recommended for initial risk assessment but this study demonstrates that people with diabetes found on monitoring to have adverse changes in HDL-cholesterol may require intensification of therapy.
“While efforts to raise HDL-cholesterol with drug therapies such as Niacin and Fibrates have so far produced disappointing results, several promising new HDL-cholesterol raising treatments have recently entered large clinical trials. However as the metabolism of HDL-cholesterol is much more complex than that of LDL-cholesterol, it remains to be seen whether any of these new treatments will be effective in preventing heart attacks and strokes, without unwanted effects.”
According to the research, most patients (61%) had no significant change in HDL levels, in 22% of patients, HDL levels increased by at least 6.5 mg/dl (milligrams per deciliter of blood), in 17% of patients, HDL levels decreased by at least that same amount. After obtaining the cholesterol measurement, researchers followed the patients for up to eight years to see if they were hospitalised for a heart attack or stroke.
Patients whose HDL levels increased had 8% fewer heart attacks and strokes than patients whose HDL levels remained the same, while patients whose HDL levels decreased had 11% more heart attacks and strokes. This study was observational so there was no intervention to change HDL levels, and although many patients were on statins to reduce their “bad” cholesterol, very few were on medications to improve HDL.
Source: Heart UK
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