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Objective: The main objective of the study was to obtain the average LDL cholesterol level in Native Americans patients with Type II DM and cardiovascular disease who are receiving their healthcare at the Albuquerque Indian Health Service. Specifically, the study determined the percentage of patients meeting the Adult Treatment Panel III recommendations of an LDL <70 for high risk patients and the cost impact to lower the LDL in those not currently at this level. High risk being defined as having coronary heart disease. Design: The study design is a combination of a chart review and review of the Resource Patient Management Systems (RPMS) of patients receiving their healthcare at Albuquerques Indian Health Services hospital/clinics. Setting/population: The population is the Native American patients receiving their healthcare at the Albuquerque Indian Health Services and includes patients with both cardiovascular disease and Type II diabetes. The sample size consisted of 14 patients with Type II diabetes; age>18y/o; had seen the PCP at least once in the last three years; had at least 1 LDL value recorded in the past year, did not have abnormal liver enzymes/liver failure; did not have abnormal kidney function tests outside of normal limits; and did not have baseline LDL> 150mg/dl. Main outcome measures: The main outcome was to determine the average LDL levels of those who are considered 'high risk' and to determine what proportion were treated to LDL<70 mg/dl. A secondary outcome assessed involved the average financial impact based upon projected attempts through lipid lowering agents to reach an LDL<70 mg/dl. Results: Twenty eight (28) percent of Albuquerque's Indian Health Service 'high risk' population is being treated to goal LDL levels. For those not currently achieving this level, Simvastatin ranging in dose from 2.5-80 mg Q PM could be utilized to bring these patient to goal levels. Simvastatin is the first line agent utilized by the Albuquerque Indian Health Services. Based on the unit pricing of this particular statin, patients can be brought to goal at an average of $10 per year/per patient. Conclusion: The conclusions of this particular research project are two fold. First in performing this research, it was found that only 28% Albuquerque's Native American population who receive their care at the Albuquerque Indian Health Service were being treated to goal. Second, the additional cost to bring these patients to recommended LDL levels is not very large.'