AFORRD study recommends statins for primary diabetes care

Results from a UK study conducted by Oxford University have shown that patients not considered by their physicians to be at high enough risk for statin therapy benefit significantly from intensive lipid lowering. Data from the AFORRD study, which were presented at the 19th world congress of the International Diabetes Federation, held in Cape Town, South Africa, was a real-world primary-care study of 800 people with type 2 diabetes. Despite recruiting patients not considered to be at high enough CVD risk to warrant statin treatment by their family doctor, it was found that 74% of the study population were actually at high estimated CVD risk (>20% over 10 years), and 94% were at moderate-to-high risk (>10% over 10 years).

In these patients, lipid lowering with 20mg of Pfizer's Lipitor (atorvastatin) reduced low-density lipoprotein cholesterol to equal to or less than 2.6mmol/l in 91% of patients (mean 1.8mmol/l) and significantly reduced the estimated 10-year CVD risk 22% (absolute risk reduction 6.7%).

"The study shows that the majority of people with type 2 diabetes in primary care are at higher cardiovascular risk than previously thought," said Andrew Neil, the study's co-principal investigator. "The new guidelines from the Joint British Societies recommend statin treatment for the majority of people with type 2 diabetes, treating to a LDL-cholesterol target of 2mmol/l. However, this advice was based on outcomes trials which recruited patients mainly in secondary care and who were at enhanced CVD risk. AFORRD shows that intensive lipid lowering for most people with diabetes is the right approach for primary care too," he added.