This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Mccallum, R. W Articles by Fisher, M. Search for Related Content Social Bookmarking                         What's this?

From 4S to FIELD and PROactive: 10 years of CV trials in people with diabetes

Miles Fisher

Wards 4 & 5, Glasgow Royal Infirmary, 84 Castle Street, Glasgow, G4 0SF, UK? miles.fisher{at}northglasgow.scot.nhs.uk

he last ten years have seen a rapid expansion in the evidence-base for the reduction of cardiovascular risk in people with diabetes.in Following the landmark Scandinavian Simvastatin Survival Study (4S), several other studies have shown the benefits of statins in people with diabetes, but much less data are available for the benefit of fibrates, and the main evidence to date comes from subgroup analysis of the Veterans Affairs High Density Lipoprotein Cholesterol Intervention Trial (VA-HIT). The Hypertension in Diabetes Study (HDS), nested within the United Kingdom Prospective Diabetes Study (UKPDS), proved that tight control of hypertension reduced microvascular and macrovascular events in people with diabetes, and the Heart Outcomes Prevention Evaluation (HOPE) and MICRO-HOPE studies suggested a benefit in reducing cardiovascular events with angiotensin-converting enzyme (ACE) inhibition, additional to blood pressure lowering effects. With regards to glycaemic therapy, the UKPDS has shown the benefit of metformin in reducing myocardial infarctions. The Fenofibrate Intervention and Event Lowering in Diabetes (FIELD) and Prospective Pioglitazone Clinical Trial in Macrovascular Events (PROactive) studies will be presented later this year and will give information on the role of fenofibrate and pioglitazone respectively in reducing cardiovascular events in people with diabetes.

Key Words: diabetes • cardiovascular disease • statins • fibrates • hypertension • ACE inhibitors • metformin

The British Journal of Diabetes & Vascular Disease, Vol. 5, No. 4, 218-225 (2005)
DOI: 10.1177/14746514050050040701


CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				R. A Ajjan and P. J Grant Cardiovascular disease prevention in patients with type 2 diabetes: the role of oral anti-diabetic agents Diabetes and Vascular Disease Research, December 1, 2006; 3(3): 147 - 158. [Abstract] [PDF]

				R. W Mccallum and M. Fisher Review: Comparing cardiovascular outcomes in diabetes studies The British Journal of Diabetes & Vascular Disease, May 1, 2006; 6(3): 111 - 118. [Abstract] [PDF]

				J. P Vora Editorial The British Journal of Diabetes & Vascular Disease, March 1, 2006; 6(2_suppl): S1 - S1. [PDF]

				M. Fisher and I. W Campbell Residual cardiovascular risk and practical management of type 2 diabetes The British Journal of Diabetes & Vascular Disease, March 1, 2006; 6(2_suppl): S17 - S23. [Abstract] [PDF]

				I. W Campbell PROactive Study: PROspective pioglitAzone Clinical Trial In macroVascular Events The British Journal of Diabetes & Vascular Disease, September 1, 2005; 5(5): 272 - 274. [PDF]