Although around two thirds of the patients reach the overall European and Swedish treatment goal of LDL-C,2.5 mmol/L, many patients still have a high residual risk. The majority of patients had HDL-C above target levels and almost half of the population have elevated TG. Furthermore, in patients with a history of CVD, more than 70% do not reach Pz-1. The treatment targets were thus not sufficiently achieved, particularly in the light of recently updated US and European treatment guidelines from year 2007 with a recommended goal for LDL-C of 2.5 mmol/L in patients with type 2 diabetes in general and 1.8 mmol/L in patients with a history of CVD. A slow improvement in overall risk factor control in Swedish patients with type 2 diabetes and coronary heart disease has been demonstrated, however, including an increased use of lipid lowering agents over time, with a corresponding improvement in blood lipid levels. From 2003 and onwards generic simvastatin has been the first line choice of lipid lowering therapy. Other agents could be used when adverse effects appear, or if the individual treatment goals are not met. In this study there were only minor differences in patient characteristics between users of simvastatin,TVB-3166 atorvastatin and rosuvastatin, apart from a slightly higher prevalence of a history of renal disease or CVD in the latter two. It is likely that a history of co-morbidities in the patients was the basis for the choice of statin in some cases, due to the presumed higher efficacy in atorvastatin and rosuvastatin. Still, the LDL-C levels are not lower than in patients taking simvastatin and the doses are low to moderate, suggesting that lipid lowering therapy is currently not consistent, and that a potential extra efficacy of atorvastatin or rosuvastatin has not been made use of. Furthermore, the results of the multivariate analysis taking clinical characteristics and LDL-C values before the treatment as well as doses of the statins into account, suggest similar LDL-C lowering effectiveness of these three agents. The weaker effects of pravastatin and fluvastatin in this study are in agreement with previous reports, although our results must be interpreted with caution due to the small sample sizes and possible selection effects.