Evaluating the benefits of treating dyslipidemia: the importance of diabetes as a risk factor.
OBJECTIVE
Diabetes mellitus is associated with an increased risk of cardiovascular disease. We compared the clinical effects of treating dyslipidemia in patients who had diabetes mellitus but no diagnosed cardiovascular disease with the effects of similar treatment in patients who had cardiovascular disease but no diabetes mellitus.


METHODS
We estimated the number of adults (ages 30 to 74 years) requiring lipid therapy using data from the third National Health and Nutrition Examination Survey and current lipid treatment guidelines. Using the Cardiovascular Life Expectancy Model, we estimated the mean increase in life expectancy that would result from lowering low-density lipoprotein cholesterol levels by 35% and increasing high-density lipoprotein cholesterol levels by 8% based on results from the Scandinavian Simvastatin Survival Study.


RESULTS
The mean number of years of life saved ranged from 3 to 3.4 years for men with diabetes versus 2.4 to 2.7 years for men with cardiovascular disease. In women, the estimated benefits were 1.6 to 2.4 years for those with diabetes versus 1.6 to 2.1 years for those with cardiovascular disease. Total population benefits were also substantial for patients with diabetes (25.4 million person-years of life saved) and those with cardiovascular disease (16.0 million person-years of life saved).


CONCLUSIONS
The clinical benefits of treating dyslipidemia in patients with diabetes should be at least equivalent to, if not more substantial than, the benefits observed among those with cardiovascular disease.
Grover
Steven A
SA
Centre for the Analysis of Cost-Effective Care, The Montreal General Hospital, Montreal, Quebec, Canada. steven.grover@mcgill.ca
Coupal
Louis
L
Zowall
Hanna
H
Weiss
Thomas W
TW
Alexander
Charles M
CM
D000328:Adult; D000368:Aged; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000517:prevention & control; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005260:Female; D006306:Health Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000453:epidemiology*; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D012016:Reference Values; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors