A recent study published in the Journal of the American Medical Association showed that aggressively treating diabetic patients with high low-density lipoprotein (LDL cholesterol) and high blood pressure to below the standard recommendations can cause regressions in coronary artery disease.

The Stop Atherosclerosis in Native Diabetics (SANDS) study looked at American Indians with type 2 diabetes, high cholesterol, and hypertension. Patients were randomly assigned to two groups - one group was treated with drugs to reach the standard targets of 100 mg/dL for LDL cholesterol and 130 mm Hg for systolic blood pressure. The other group was treated to reach a target of 70 mg/dL for LDL and 115 mg Hg for systolic blood pressure. Although both groups experienced low rates of heart-related events after 12 months, only the aggressively treated group demonstrated regression in the fatty deposits lining their coronary arteries. The aggressive treatment group also experienced greater decreases in the mass of the left ventricle, the chamber of the heart that is primarily responsible for pumping blood to the rest of the body.

The investigators emphasize that, since both groups had a low number of cardiovascular events, the standard recommendations still seem to be effective. It is also not known if the regression in coronary artery disease and left ventricular mass translates into reductions in the risk of heart attack or stroke. Since the patients in this study were only followed for 1 year, it remains to be seen what the effects of aggressive cholesterol and blood pressure lowering treatment are in the long-term.