Sulfonylurea Use, Cardiovascular Disease Connection Reviewed

the MPR take:

In women with diabetes, long-term use of sulfonylureas may be associated with an increased risk of developing coronary heart disease (CHD), says a new study published in the journal Diabetes Care. The study involved 4,902 women with diabetes over a mean duration of 11 years; the women did not have evidence of cardiovascular disease at baseline. The primary outcome was to determine the risk for the association between sulfonylurea use and incident cardiovascular disease. During the time period of the study, 191 cases of CHD and 148 cases of stroke were identified. The risk of CHD was greatest in women who used sulfonylurea therapy for the longest duration: 2.15 (>10 years) vs. 1.24 (1–5 years) and 1.51 (6–10 years). The risk of CHD was also greater in patients taking the combination of metformin + sulfonylurea compared to patients on metformin monotherapy. Based on these findings, researchers conclude that there is a significant risk for developing CHD in women who are on long-term sulfonylurea therapy; no significant association was seen between sulfonylurea use and stroke risk.

Evidence is inconsistent for the association between sulfonylurea use and risk of cardiovascular disease among patients with diabetes. We aimed to prospectively evaluate this association using the Nurses' Health Study (NHS), a well-established cohort of U.S. women with long-term follow-up.

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