Abstract | BACKGROUND: Intensive lipid-lowering therapy is recommended in type 2 diabetes mellitus (T2DM) patients with target organ damage. However, the evidence is insufficient to stratify the patients who will benefit from the intensive therapy among them. High visit-to-visit variability in systolic blood pressure (SBP) is associated with increased risk of cardiovascular events. We investigated the effectiveness of intensive versus standard statin therapy in the primary prevention of cardiovascular events among T2DM patients with retinopathy stratified by visit-to-visit SBP variability. METHODS: RESULTS: In a total of 4899 patients, 240 composite cardiovascular events were observed during a median follow-up of 37.3 months. In multivariable-adjusted model comparing intensive versus standard therapy, the hazard ratios for composite cardiovascular events were 0.64 (95% CI 0.45-0.90) and 1.21 (95% CI 0.82-1.80) in patients with high and low SBP variability as defined by SD, respectively. Interaction between SBP variability and statin therapy was significant (P = 0.018). The analysis using ARV of SBP showed similar results. CONCLUSION:
Statin intensive therapy targeting LDL-C <70 mg/dl had benefits in primary prevention of cardiovascular events compared with standard therapy among T2DM patients with retinopathy having high, but not low, visit-to-visit SBP variability.
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Authors | Shota Ikeda, Keisuke Shinohara, Nobuyuki Enzan, Shouji Matsushima, Takeshi Tohyama, Kouta Funakoshi, Junji Kishimoto, Hiroshi Itoh, Issei Komuro, Hiroyuki Tsutsui |
Journal | Journal of hypertension
(J Hypertens)
Vol. 39
Issue 7
Pg. 1435-1443
(07 01 2021)
ISSN: 1473-5598 [Electronic] Netherlands |
PMID | 34001809
(Publication Type: Journal Article)
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Copyright | Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved. |
Chemical References |
- Cholesterol, LDL
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Topics |
- Blood Pressure
- Cardiovascular Diseases
(prevention & control)
- Cholesterol, LDL
- Diabetes Mellitus, Type 2
(complications, drug therapy)
- Humans
- Hydroxymethylglutaryl-CoA Reductase Inhibitors
(pharmacology, therapeutic use)
- Hypertension
- Risk Factors
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