Anil K. Gollapudi, MD
Potential Financial Conflicts of Interest: None disclosed.
Gollapudi A.; Do Lipid-Lowering Agents Provide a Greater Reduction in Cardiovascular Events among Patients with Diabetes?. Ann Intern Med. 2008;149:841. doi: 10.7326/0003-4819-149-11-200812020-00023
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Published: Ann Intern Med. 2008;149(11):841.
TO THE EDITOR:
The U.S. Preventive Services Task Force (USPSTF) no longer recommends routine screening for type 2 diabetes mellitus in adults with hyperlipidemia (1). This recommendation seems to have been based, at least in part, on an analysis of the secondary prevention trials, which showed that lipid treatment reduced the incidence of coronary heart disease (CHD) events by about the same relative percentage among those with type 2 diabetes mellitus and those without.
Because the incidence of major CHD events is higher in adults with type 2 diabetes mellitus than in those without, one would expect that patients with diabetes would benefit more by having greater absolute reductions in CHD events than patients without diabetes despite similar reductions in relative percentage. Therefore, reductions in absolute percentage (and not relative percentage) of CHD events with lipid treatment in these groups should have been considered.
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