Increasing ‘good’ cholesterol may lower CVD risk for diabetics
Writing in the American Journal of Cardiology, researchers from the Kaiser Permanente Center for Health Research, USA, reported that increasing the levels of high-density lipoproteins, known as HDL or ‘good’ cholesterol, could reduce the risk for heart attack and stroke among patients with diabetes.
"Our study adds to the growing body of evidence that raising HDL levels may be an important strategy for reducing heart attack risk," said Dr Gregory Nichols of Kaiser Permanente – who led the study.
“We also observed a substantial 11% increase in the risk of CVD hospitalization among patients who experienced at least a 6.5-mg/dl decrease in the HDLcholesterol level, suggesting that the prevention of a HDL cholesterol decrease might be at least as important as increasing the HDL cholesterol level,” added the researchers.
Nichols and his team noted that the lifetime risk of cardiovascular disease (CVD) “is as great as 87% among patients with type 2 diabetes.”
They said added that whilst there is considerable evidence that reducing the amount of low-density lipoprotein, also known as LDL or ‘bad’ cholesterol, can reduce the risk of heart disease, the relationship between HDL cholesterol and heart disease is less clear.
The newly reported study, one of the largest observational studies of its kind, and examined the medical records of more than 30,000 patients with diabetes who entered Kaiser Permanente diabetes registries in the USA between 2001 and 2006 – all patients had at least two HDL cholesterol measurements between 6 and 24 months apart.
The researchers found that most patients (61%) had no significant change in HDL levels; whilst in 22% of patients HDL levels increased by at least 6.5 mg/dl; and 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 8 years to see if they were hospitalized for a heart attack or stroke.
Nichols and his team reported that 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 is promising news for patients with diabetes, who already have an increased risk for heart problems. Raising their good cholesterol may be one more way for these patients to reduce their risk," said Dr Suma Vupputuri a co-author of the study, also based at the Kaiser Permanente Center for Health Research.
Source: The American Journal of Cardiology
Volume 108, Issue 8, Pages 1124-1128, doi: 10.1016/j.amjcard.2011.05.047
“Change in High-Density Lipoprotein Cholesterol and Risk of Subsequent Hospitalization for Coronary Artery Disease or Stroke Among Patients With Type 2 Diabetes Mellitus”
Authors: G.A. Nichols, S. Vupputuri, A.G. Rosales