studies involving cholesterol lowering in patients with coronary heart disease have also
included diabetic subjects and are shown in this slide. Both trials involved used a
statin. The first, the 4S, was in high risk hypercholesterolemia patients who have had an
MI or other evidence of CHD. They experienced a dramatic 54% reduction on Simvastatin. The
second study, CARE, was designed to look at the reduction of cholesterol in post MI
patients with relatively normal cholesterol levels (which in fact are the bulk of subjects
with MI). This study also included patients with diabetes. Again there was a significant
reduction in macrovascular recurrent events in those treated with Pravastatin.
Consequently, the lowering of cholesterol in Type 2 diabetes to prevent recurrent events
in those with heart disease is well established and should be advocated vigorously.