Scientists tailor cholesterol-lowering treatment for diabetic heart health

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Statins, well-known for their cholesterol-lowering capabilities, are vital in preventing heart disease.

A collaborative study by the University of Manchester, Manchester University NHS Foundation Trust (MFT), and Keele University has broken new ground.

Funded by the National Institute for Health Research (NIHR), this study identifies the most effective statins for reducing all types of harmful cholesterol and lessening heart disease risk in individuals with diabetes, supporting recent guidelines from the National Institute for Health and Care Excellence (NICE).

Cholesterol, Diabetes, and Heart Risks

Bad cholesterol, specifically non-high-density lipoprotein cholesterol (non-HDL-C), can build up in blood vessels, raising the risk of dangerous blood clots. Those with diabetes are at a heightened risk for cardiovascular diseases. Thus, managing cholesterol is crucial.

This research aimed to pinpoint which among the seven commonly used statins are best at lowering non-HDL-C levels, a key indicator of cardiovascular risk.

While it’s known which statins lower low-density lipoprotein cholesterol (LDL-C), their effectiveness on non-HDL-C, which includes LDL-C and other harmful cholesterols, was unclear.

Non-HDL-C is now the main focus in cholesterol-lowering strategies to reduce heart disease risk. It’s easily calculated by subtracting good cholesterol (HDL-C) from total cholesterol levels.

Key Discoveries

  1. Most Effective Statins: Rosuvastatin (moderate and high doses), along with simvastatin and atorvastatin (high doses), emerged as the top choices for lowering non-HDL-C in diabetic patients. These medications reduced non-HDL-C by about 2.20 to 2.31 mmol/l over 12 weeks.
  2. High-Risk Patient Focus: For patients with a significant risk of major cardiac events, high-dose atorvastatin was particularly effective, reducing non-HDL-C by around 2.0 mmol/l.

Aligning with NICE Guidelines

The study’s findings are in step with updated NICE guidelines that favor using non-HDL-C over LDL-C as a more accurate indicator for cardiovascular risk in cholesterol-lowering treatments.

Although NICE hasn’t specifically recommended these three statins, the study provides crucial insights into the effectiveness of statins, using non-HDL-C as the preferred benchmark.


For people with type 2 diabetes, who face a higher risk of heart disease, statins are key to preventing heart complications.

This study suggests that healthcare providers should focus on non-HDL-C as a primary measure of heart risk, as it’s easy to compute and adds little extra work.

The three most effective statins identified—rosuvastatin, simvastatin, and atorvastatin—offer valuable guidance for selecting and dosing statins, helping healthcare professionals balance benefits and risks.

These insights are especially beneficial for those with diabetes and their healthcare teams, aiming to improve heart health and lower the risk of heart disease.

The study adds an important chapter in diabetes care, offering a refined approach to managing heart health in diabetic patients.

The research, offering a clear direction for better cardiovascular care in diabetes, is available in BMJ.

If you care about heart health, please read studies about the best time to take vitamins to prevent heart disease, and scientists find how COVID-19 damages the heart.

For more information about diabetes, please see recent studies about how to eat to prevent type 2 diabetes, and 5 vitamins that may prevent complication in diabetes.

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