积极降压降脂可降低糖尿病患者心血管风险
Drug regime reverses heart disease in diabeticsCHICAGO (Reuters) - Aggressive use of drugs to lower cholesterol and blood pressure helped reverse heart disease in people with diabetes, U.S. researchers said on Tuesday.
芝加哥（路透社）-大胆使用降胆固醇药和降压药有助于糖尿病人心脏病的彻底改善，US研究人员星期二如是说。
The three-year study of 499 Native American adults with type-2 diabetes showed that lowering blood pressure and cholesterol more than is usually recommended helped reverse thickening of the arteries and damage to the heart.
来自美国本土的499例患2型糖尿病的成年患者参与了为期3年的研究，结果表明，降压和降低胆固醇有助于逆转动脉管壁增厚和心脏的损害。
This is good news for everyone with diabetes, the researchers said -- especially Native Americans, who have high rates of the disease.
研究者说，对于所有糖尿病患者尤其是发病率比较高的美国人而言，无疑是个令人振奋的消息。
\"These patients are two to four times more likely than people without diabetes to die from heart disease,\" said Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute.
国立心肺血液研究所主任Elizabeth Nabel博士说：“这些患者死于心脏病的风险要比没有糖尿病的人群高出2到4倍。”
\"For the first time, we have evidence that aggressively lowering LDL cholesterol and blood pressure can actually reverse damage to the arteries in middle-aged adults with diabetes.\"
“第一次，我们有证据显示，在中年糖尿病患者中，降低胆固醇和血压能明显逆转动脉病变。
But other experts said the study, published in the Journal of the American Medical Association, did not resolve the debate over how low to go.
但是别的专家认为，发表在《美国医学会期刊》上的该项研究并不能解决关于“多么低”的争论问题。
Advocates of aggressive treatment with cholesterol-lowering statins and blood pressure drugs argue the lower, the better, though conclusive data to support that view is lacking, wrote Duke University's Eric Peterson in a commentary.
杜克大学的Eric Peterson在一篇评论中写道，大胆使用他汀类降脂药和降压药治疗的支持者主张越低越好，尽管缺乏支持该观点的结论性数据。
\"We know now that it's important to control risk factors for heart disease in people with diabetes, yet we don't know how far to aim,\" said Barbara Howard, who conducted the U.S. government-funded study with colleagues at MedStar Research in Hyattsville, Maryland.
来自马里兰州海特斯维尔MedStar 研究所的Barbara Howard说，我们知道控制糖尿病患者中的心脏病风险很重要，而我们不知道实现这一目标还有多远。他和同事们一起主导了由US政府资助的该项研究。
The group receiving standard care had targets of low density lipoprotein -- \"bad\" LDL cholesterol -- of 100 milligrams per deciliter or lower, and systolic blood pressure (the higher number when the heart contracts) of 130 or lower. Those treated more aggressively had targets of 70 milligrams of cholesterol and blood pressure level of 115 or lower.
接受标准治疗的病人有低密度脂蛋白的指标即坏的LDL胆固醇——100mg/dl或者更低，并且收缩压（当心脏收缩时的高值）为130或更低。而接受冒险治疗的患者其胆固醇水平被限定在70mg，血压水平为115或者更低。
Blood pressure and statin drugs were provided to patients by Merck and Co and Pfizer Inc..
患者服用的降压药和他汀类药物由默克公司和辉瑞公司提供。
Ultrasound measurements taken of the carotid artery in the patients' necks -- a reliable indicator of hardening or thickening of the arteries that is a precursor to heart disease -- showed improvement in those treated aggressively with statins.
超声检测患者颈动脉（一种可靠的心脏病前兆动脉增厚或硬化的诊断方法）的结果显示，大胆使用他汀药有所改善。
\"We found that in the aggressive group there was actually a reduction in the thickness of the vessel in the neck as compared to the standard group whose neck vessels got a little bit worse ... That has not been seen in most studies,\" Howard said.
Howard说：“我们发现，与标准组的颈动脉血管壁有所恶化相比，冒险组的颈动脉管壁厚度有明显的下降。在很多研究中都没有发现这一结果。”
Measures of the heart's main pumping chamber found enlargement at the beginning of the study -- a sign of potential heart trouble -- was reduced by the blood pressure drugs, and shrinkage was greater in the aggressive group.
研究初期发现心脏泵房增大——心脏发病的征兆，通过使用降压药得以减小，并且在冒险组减低明显。
Howard predicted the observed changes would lead to fewer heart attacks and strokes among aggressively treated patients.
Howard预测，观察到的改变直接降低了接受冒险治疗的病人的心脏病和卒中风险。
The study did not last long enough to find such a difference, though patients will continue to be tracked and additional research may draw a firmer conclusion.
尽管患者还将继续被跟踪研究，并且额外的研究也可能得出肯定的结论，但该项研究并没有持续足够长的时间以至于发现这种差异。
Diabetes kills an estimated 284,000 people in the United States each year, up to 65 percent of them from heart and artery disease, according to the NHLBI.
根据NHLBI（美国国立心肺血液研究所），美国每年有284000人死于糖尿病，其中高达65%的人患有心脏病和动脉疾病。
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