Antidiabetic Agents May Harm the Heart in Non-Diabetics

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Antidiabetic Agents May Harm the Heart in Non-Diabetics

Reuters Health Information 2005. © 2005 Reuters Ltd.

Republication or redistribution of Reuters content, including by framing or

similar means, is expressly prohibited without the prior written consent of

Reuters. Reuters shall not be liable for any errors or delays in the

content, or for any actions taken in reliance thereon. Reuters and the

Reuters sphere logo are registered trademarks and trademarks of the Reuters

group of companies around the world.

NEW YORK (Reuters Health) Apr 28 - In a study of non-diabetic African

Americans with insulin resistance, the long-term use of oral antidiabetic

agents was associated with an increase in aortic pulse wave velocity (PWV),

which is consistent with a decrease in the elastic properties of the aorta.

" It has been shown previously that increased PWV is an indicator of a high

incidence of cardiovascular events and an independent predictor of cardiac

mortality, " study investigators note in the May issue of the journal Heart.

Therefore, " the use of oral antidiabetic agents for the prevention of

cardiovascular complications in non-diabetic African Americans with insulin

resistance needs to be critically evaluated, " they conclude.

It has been suggested that improving insulin sensitivity, perhaps with oral

antidiabetic agents, in insulin resistant non-diabetic individuals may delay

the development of diabetes and its related cardiovascular complications.

But data are lacking on the long-term cardiovascular effects of these agents

in non-diabetic populations.

To investigate, Dr. Harisios Boudoulas from the Academy of Athens in Greece

and associates randomly assigned 181 normoglycemic African Americans, but

with insulin resistance, to glipizide (5 mg/day), metformin (500 mg/day) or

placebo for 24 months.

They observed a significant increase in aortic PWV in both glipizide- and

metformin-treated subjects, with p values of 0.012 and 0.01, respectively.

In contrast, aortic PWV remained unchanged in the placebo arm.

The increase in PWV in the two active treatment arms was significant

relative to placebo (analysis of variance p < 0.05).

" No other cardiovascular or metabolic variable changed significantly during

the follow up period, " they note.

In a multivariate analysis, treatment with glipizide or metformin " was the

only independent predictor of changes in PWV during the follow up period. "

The investigators note that the precise mechanism or mechanisms responsible

for the effects of these agents on aortic function are unknown and deserve

further study.

Heart 2005;91:589-594.

[Guest guest]

Hi All,

The pdf is available for the below.

Stakos DA, Schuster DP, Sparks EA, Wooley CF, Osei K, Boudoulas H.

Long term cardiovascular effects of oral antidiabetic agents in non-diabetic

patients with insulin resistance: double blind, prospective, randomised study.

Heart. 2005 May;91(5):589-94.

PMID: 15831640

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve & db=pubmed & dopt=Abstra\

ct & list_uids=15831640

--- Al Young <acyoung@...> wrote:

>

> Antidiabetic Agents May Harm the Heart in Non-Diabetics

>

>

> Reuters Health Information 2005. © 2005 Reuters Ltd.

> Republication or redistribution of Reuters content, including by framing or

> similar means, is expressly prohibited without the prior written consent of

> Reuters. Reuters shall not be liable for any errors or delays in the

> content, or for any actions taken in reliance thereon. Reuters and the

> Reuters sphere logo are registered trademarks and trademarks of the Reuters

> group of companies around the world.

>

>

>

> NEW YORK (Reuters Health) Apr 28 - In a study of non-diabetic African

> Americans with insulin resistance, the long-term use of oral antidiabetic

> agents was associated with an increase in aortic pulse wave velocity (PWV),

> which is consistent with a decrease in the elastic properties of the aorta.

>

> " It has been shown previously that increased PWV is an indicator of a high

> incidence of cardiovascular events and an independent predictor of cardiac

> mortality, " study investigators note in the May issue of the journal Heart.

>

> Therefore, " the use of oral antidiabetic agents for the prevention of

> cardiovascular complications in non-diabetic African Americans with insulin

> resistance needs to be critically evaluated, " they conclude.

>

> It has been suggested that improving insulin sensitivity, perhaps with oral

> antidiabetic agents, in insulin resistant non-diabetic individuals may delay

> the development of diabetes and its related cardiovascular complications.

> But data are lacking on the long-term cardiovascular effects of these agents

> in non-diabetic populations.

>

> To investigate, Dr. Harisios Boudoulas from the Academy of Athens in Greece

> and associates randomly assigned 181 normoglycemic African Americans, but

> with insulin resistance, to glipizide (5 mg/day), metformin (500 mg/day) or

> placebo for 24 months.

>

> They observed a significant increase in aortic PWV in both glipizide- and

> metformin-treated subjects, with p values of 0.012 and 0.01, respectively.

> In contrast, aortic PWV remained unchanged in the placebo arm.

>

> The increase in PWV in the two active treatment arms was significant

> relative to placebo (analysis of variance p < 0.05).

>

> " No other cardiovascular or metabolic variable changed significantly during

> the follow up period, " they note.

>

> In a multivariate analysis, treatment with glipizide or metformin " was the

> only independent predictor of changes in PWV during the follow up period. "

>

> The investigators note that the precise mechanism or mechanisms responsible

> for the effects of these agents on aortic function are unknown and deserve

> further study.

>

> Heart 2005;91:589-594.

>

>

Al Pater, PhD; email: old542000@...

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