Is diabetes the cost to pay for a greater cardiovascular prevention?

• Published in: International journal of cardiology Vol. 144; no. 2; pp. 309 - 310
• Main Authors: Rizzo, Manfredi, Spinas, Giatgen A, Rini, Giovam Battista, Berneis, Kaspar
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 08-10-2010; Elsevier
• Subjects: Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular Diseases - prevention & control; Cardiovascular risk; Diabetes; Diabetes Mellitus - chemically induced; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Fluorobenzenes - adverse effects; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Medical sciences; Prevention; Pyrimidines - adverse effects; Rosuvastatin Calcium; Statins; Sulfonamides - adverse effects; Prevention; Diabetes; Statins; Atherosclerosis; Cardiovascular risk; Endocrinopathy; Costs; Diabetes mellitus; Cardiovascular disease; Statin derivative; Vascular disease; Health economy; Risk factor; Cardiology; Public health
• ISSN: 0167-5273; 1874-1754
• DOI: 10.1016/j.ijcard.2009.03.001

Abstract The recent JUPITER (Justification for the Use of statins in Primary prevention: an Intervention Trial Evaluating Rosuvastatin) trial is another study providing evidence about the effectiveness of statin therapy in reducing cardiovascular risk. Yet, in this study significantly higher glycated hemoglobin levels and incidence rates of diabetes were observed in persons treated with rosuvastatin than the placebo group. It should be noted that adverse effects on glucose metabolism have already been reported, albeit rarely, in previous trials with statins. Although the exact mechanisms involved are unknown, it seems that statins may deteriorate glycemic control by decreasing different metabolites, including isoprenoid and ubiquinone, normally produced during the process of cholesterol synthesis. We therefore suggest that, if statins are prescribed, patients should be monitored closely for blood glucose control even though the higher incidence of diabetes by statin therapy may represent a rare finding.