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:2/16/2017)... 2017  AcelRx Pharmaceuticals, Inc. (Nasdaq: ... the development and commercialization of innovative therapies for ... Vincent J. Angotti has been appointed ... company,s board of directors, effective Monday, March 6, ... experience leading executive and commercial teams at public ...
(Date:2/16/2017)... , Feb. 16, 2017  Prescription pain medications ... department visit are necessary for long-term opioid use to ... Feb. 16 th edition of The New ... "Emergency physicians see more patients in acute pain than ... Parker , MD, FACEP, president of the American College ...
(Date:2/16/2017)... Research and Markets has announced the addition of the ... Function, Application, Cancer Type, Technology - Forecast to 2025" report ... ... grow at a CAGR of around 28.6% over the next decade ... Some of the prominent trends that the market is witnessing include ...
Breaking Medicine Technology:
(Date:2/18/2017)... ... February 17, 2017 , ... Focused ... innovation in the industry, according to the recent NEJM Catalyst Insights Report on ... of the NEJM Catalyst Insights Council, a qualified group of U.S. executives, clinical ...
(Date:2/18/2017)... ... 2017 , ... A new directory from the Senior Veterans ... connect elderly veterans of America's armed forces to a range of senior care ... on this year's increase in the Veterans Pension with Aid & Attendance for ...
(Date:2/17/2017)... ... 2017 , ... For the first time, International Scholarship and ... floor for the 2017 HIMSS Conference & Exhibition at the Orange ... than 40,000 healthcare industry professionals are expected at the conference, where they will ...
(Date:2/17/2017)... ... February 17, 2017 , ... Access today ... Exhibition in Orlando, Fla., February 19-23. Visitors to the company’s booth (#1778) will ... used electronic patient signatures solution in healthcare . , Since it first ...
(Date:2/17/2017)... ... February 17, 2017 , ... Cancer diagnostics workflow solution provider ... 20 – 22 in San Francisco. As part of the Tri-Conference expo, which ... workflow solution, as well as its new precision medicine platform, “Crosswalk Insight: Oncology™.” ...
Breaking Medicine News(10 mins):