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S A N D S
Stop Atherosclerosis
in Native Diabetics Study |
Phoenix,
Arizona |
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Summary Although
once protected from cardiovascular disease (CVD), American Indians now have incidence
rates higher than the general US population. The majority of CVD cases occur
in individuals with diabetes. It is therefore imperative that intervention
strategies to reduce CVD in individuals with diabetes be developed and
validated in this population. This
study was a randomized 3-year trial to examine the effects on CVD of
intensive LDL reduction (goal £70
mg/dL) and intensive blood pressure lowering (goal £115/75
mmHg), compared to usual targets of £100
mg/dL and £130/80
mmHg. These cutpoints were chosen because mean LDL and blood pressure levels
are lower in this population, but there are strong relations between LDL,
blood pressure, and CVD at levels below current targets. The primary endpoint
was carotid intimal-medial thickness (IMT). Secondary endpoints included
cardiac function measures by echocardiography, lipoproteins, albuminuria, and
C-reactive protein (CRP). Data analysis used a non-parametric approach in
order to include incident non-fatal and fatal events. The
study enrolled 499 American Indian men and women with diabetes, > 40 years
of age and was conducted in four field centers involving Indian Health
Service/Tribal primary care facilities in Phoenix/Sacaton, Arizona; Chinle,
Arizona; Rapid City/Pine Ridge, South Dakota; and Lawton, Oklahoma, with
input from American Indian physicians and community members. For both
randomization groups a stepped approach was employed using approved blood
pressure and lipid lowering agents. Study results provided evidence needed to
develop community-based programs to treat and prevent the epidemic of CVD
among American Indians. The data is valuable in understanding the effects of
intensive risk-factor reduction on atherosclerosis burden and cardiac
function in individuals with diabetes in all US populations and provide
evidence for determining LDL and blood pressure treatment goals for patients
with diabetes. This
study was conducted from 9/30/2002
to 8/31/2007. Please follow this link (Medstar Research Institute)
to learn more about SANDS. |
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This website is developed and maintained by Center for American Indian Health Research The
University of Oklahoma Health Sciences Center Last
update: 3-31-2008 |
Chinle,
Arizona |
