Navigation Links
American Heart Association/American College of Cardiology Joint Science Advisory: AHA/ACC Issue Advisory on Diabetes Drugs and Heart Risk
Date:2/23/2010

DALLAS, Feb. 23 /PRNewswire-USNewswire/ -- The data are inconclusive on heart risks from a class of blood sugar-lowering drugs called thiazolidinediones (TZDs) such as pioglitazone (Actos) or rosiglitazone (Avandia), but the medications should be used with close monitoring from healthcare providers according to a joint science advisory from the American College of Cardiology and the American Heart Association.

The advisory is published online in both Circulation: Journal of the American Heart Association and Journal of the American College of Cardiology.

The U.S. Senate Finance Committee released a report on Saturday following a two-year inquiry into the safety of the diabetes drug rosiglitazone, and the possibility of an increased incidence of adverse cardiovascular events.  Resulting news coverage has highlighted uncertainties about research on TZDs.  

"Research is ongoing and more is needed to understand which agents, including TZDs, work best for diabetes control," said Clyde Yancy, M.D., president of the American Heart Association.  

The purpose of the advisory is to summarize the currently available data concerning TZDs and cardiovascular risk, and provide practical recommendations to healthcare workers seeking to minimize the burden of cardiovascular disease and other complications in their patients with type 2 diabetes mellitus.

"Science is constantly evolving and physicians should carefully evaluate all research on this topic," said Alfred A. Bove, M.D., president of the American College of Cardiology. "Patients should feel comfortable bringing any medical concerns to their physicians."

"Patients with diabetes are at increased risk for heart disease and stroke and should adopt comprehensive treatment strategies that include diet, activity and a medical regimen that works best to achieve optimal control of blood sugar," Yancy added.  "A good relationship with a care provider is the best step for any patient with diabetes to take."

Take-away messages for patients with diabetes:

  • Focus on glycemic (blood sugar) control keeping your HbA1c levels below 7.0% to reduce the risk of the "microvascular" complications of diabetes, such as kidney failure, painful nerve problems, and decreased vision or even blindness.
  • The cornerstone of treatment should be healthy lifestyle choices (a healthy diet and regular physical activity) and optimal control of blood pressure and lipids (such as cholesterol and triglycerides).  An aspirin regimen should be used under the advice of a physician in patients who have known cardiovascular disease due to atherosclerosis.
  • With regards to glucose-lowering medications,
    • Metformin should generally be the first choice, particularly in obese patients.  If it does not produce adequate HbA1c control, other medications can be considered, recognizing that the fund of knowledge about the effect of other glucose-lowering agents on cardiovascular risk is sparse.
    • If a TZD (such as pioglitazone or rosiglitazone) is considered for this purpose, it should not be used with an expectation of benefit in reducing the occurrence of heart attack or stroke, and the rationale for the choice of a TZD should be discussed with your physician.  However, patients who have successfully achieved recommended HbA1c control on a TZD might consider remaining on their medication.  If the treating physician and/or the patient is uncomfortable with using a TZD, another medication could be substituted.  There is currently not enough data to support the choice of a specific TZD.

According to the joint advisory:

  • Diabetes mellitus is increasing in prevalence in the United States and worldwide.  An estimated 23.6 million people in the United States, 7.8% of the population, had diabetes in 2007, with more than 90% of cases being type 2 diabetes mellitus.
  • Diabetes increases the risk of CVD events by 2- to 4-fold, and CVD accounts for nearly two thirds of deaths among diabetic patients.
  • Among people who experience CVD events, diabetes is highly prevalent: 45% of those hospitalized for heart attack have known or previously undiagnosed diabetes.
  • Diabetes is also an independent predictor of secondary adverse events, such as reinfarction, heart failure, and death.

Advisory writing committee members include Sanjay Kaul, M.D., Chair; Ann F. Bolger, M.D.; David Herrington, M.D.; Robert P. Giugliano, M.D., ScM and Robert H. Eckel, M.D.  Author disclosures are on the manuscript.

SOURCE American Heart Association

Back to top
'/>"/>
SOURCE American Heart Association
Copyright©2010 PR Newswire.
All rights reserved

Related medicine technology :

1. Americans Living Longer, Healthier Lives Due to Medical Innovation and New Therapies
2. Many Americans Enjoying Longer, Healthier Lives Due to Medical Innovation and New Therapies
3. American Heart Association Rapid Access Journal Report: Implanted Monitor Accurately Detects Heart Rhythm Disturbances
4. HearUSA Introduces AARP Hearing Care Program for Americans Aged 50-plus in Ohio Today
5. HearUSA Introduces AARP Hearing Care Program for Americans Aged 50-plus in Michigan Today
6. HearUSA Introduces AARP Hearing Care Program for Americans Aged 50-plus in Massachusetts Today
7. HearUSA Introduces AARP Hearing Care Program for Americans Aged 50-plus in North Carolina Today
8. HearUSA Introduces AARP Hearing Care Program for Americans Aged 50-plus in Missouri Today
9. HearUSA Introduces AARP Hearing Care Program for Americans Aged 50-plus in Pennsylvania Today
10. The American Academy of Pain Medicine Announces this Years Presidential Commendations and Awards
11. Mylan Awarded NABP-VAWD Accreditation for Its Primary North American Distribution Facility
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/10/2016)... 2016  Silicon Biosystems Menarini Inc., a developer ... uncover the biological complexities of disease at the ... of innovative technologies for genomics research, today announced ... enabling translational researchers to obtain high-quality sequencing results ... and normal cells in an optimized and seamless ...
(Date:2/10/2016)... -- Until recently, the options for reducing the appearance of ... approved the non-invasive Coolsculpting treatment, which removes fat cells ... in 2010 for the abdomen and this approval was ... this add-on approval, the experts at Laser Therapy Health ... CoolMini, to address smaller areas of fat. ...
(Date:2/10/2016)... 2016 --> ... and Companion Diagnostic Market to 2019 - Strategic ... research report indicates that the core personalized medicine ... 2020 growing at a CAGR of 8.74%. This ... targeted therapeutics and is dominated by oncology, cardiovascular ...
Breaking Medicine Technology:
(Date:2/10/2016)... ... February 10, 2016 , ... Dr. Jessica Barron, of Barron Family Dental ... dental patients and families in the North Metro Denver area. The new dental practice ... cosmetic dentistry, and all in the most relaxing environment. , While some dental visits ...
(Date:2/10/2016)... , ... February 10, 2016 , ... Gout is like ... brings pain that is often severe, with intense swelling and redness. It is triggered ... million people, but older adults are the most susceptible, according to the February 2016 ...
(Date:2/10/2016)... ... February 10, 2016 , ... Pediatric therapists ... their patients. Research shows that the Goal Attainment Scale (GAS) captures 20% more ... challenge and learn more about the Goal Attainment Scale, Education Resources Inc. is ...
(Date:2/10/2016)... ... February 10, 2016 , ... Everseat has joined ... readily available to physicians. The integration will enable Allscripts users to post open ... Everseat’s free mobile app. , The partnership gives Everseat substantial added power to ...
(Date:2/10/2016)... ... 10, 2016 , ... Workrite Ergonomics, who is celebrating their 25th year of ... to being an internationally recognized leader in their industry. , "We are very proud ... President of Workrite. “Workrite recognized the importance of good ergonomics before most of ...
Breaking Medicine News(10 mins):