Abstract 14293: Does Therapy With Statins Increase Risk Of Diabetes?
Background: The ESC/ESH guidelines for management of arterial hypertension recommend use of statins for primary and secondary prevention in all patients with high cardiovascular (CV) risk. A recent meta-analysis, combining results of previous studies, suggests that statin prescription is associated with 9% increased risk of diabetes. Most of those studies enrolled patients with high CV risk for clusters of risk factors or for prevalent CV disease. There is no clinical evidence that statin therapy increases risk of incident diabetes in hypertensive patients without prevalent CV disease.
Methods: We evaluated risk of incident diabetes in relation to statin therapy in 1760 hypertensive, non-diabetic participants of the Campania Salute registry (mean age 52±12 yrs, 57% male), without prevalent CV disease, more than stage 3 chronic kidney disease and with at least 12 months of follow-up. Incident diabetes was defined according to 1997 ADA criteria.
Results: Over 3.5±1.8 yrs of follow-up, 13.5% of patients were on statins at the last available visit. Patients on statins were older (57±10 vs 51±12 yrs; p<0.0001), more often female (52% vs 42%; p = 0.003), had higher baseline plasma cholesterol and triglycerides (both p<0.0001), than those not taking statins, but body mass index (BMI), plasma glucose and blood pressure were similar. At the end of the follow-up period, prevalence of new diabetes was 13% in patients on statins and 5% in those not taking statins (OR=2.99, 1.92-4.7, p<0.0001). Thus, prescriptions of statins were also compared at the last visit preceding the first lab evidence of diabetes, or at the last available visit in the absence of incident diabetes. No significant difference was found (6.4% in patients with and 5.9% in those without incident diabetes ).
Conclusions: In a large clinical sample of hypertensive, non-diabetic patients, statin therapy is not associated with a significant increased risk of incident diabetes, but is more likely prescribed in patients with high risk of diabetes. Previous findings on this association are likely to be influenced by the high risk phenotype of patients developing diabetes.
- © 2010 by American Heart Association, Inc.