[Expert consensus on initial combination lipid-lowering therapy in patients with type 2 diabetes mellitus and...

The prevalence of hypertension in patients with type 2 diabetes mellitus is as high as 60% to 76%, and the coexistence of these two conditions further increases the risk of atherosclerotic cardiovascular disease (ASCVD). Lipid management is a critical component in the prevention and management of ASCVD. Recent studies have shown that initiating combination lipid-lowering therapy, compared with statin monotherapy, leads to a more rapid and significant reduction in low-density lipoprotein cholesterol (LDL-C) levels and significantly lowers the risk of cardiovascular events. To further clarify the initial combination lipid-lowering strategy for patients with type 2 diabetes mellitus and hypertension, experts in cardiology and endocrinology collaborated to develop this consensus. The consensus emphasizes that, on the basis of lifestyle interventions, active initiation of combination therapy with statins and cholesterol absorption inhibitors, supplemented with proprotein convertase subtilisin/kexin type 9 inhibitors when necessary, should be implemented to reduce LDL-C to target levels as early as possible. For patients with hypertriglyceridemia, the addition of icosapent ethyl or fibrates is recommended to further reduce residual cardiovascular risk or the risk of pancreatitis.