Type 2 drug sulfonylureas ‘raises heart failure risk in men’
Men who are treated with the type 2 diabetes drug sulfonylureas are at more risk of heart failure and cardiovascular death than those who take metformin, new research has suggested.
A recent study looked at medications which impact insulin sensitivity or cause weight gain and how it may increase the person’s chance of suffering from heart problems.
People aged 18 years or over who started taking either metformin or sulfonylureas between 2001 and 2011 and whose creatinine was <1.4 (females) or 1.5 mg/dL (males) were included.
Each person who had been taking metformin was propensity scored and matched to someone who had been using sulfonylurea to control their diabetes.
The outcome was hospitalisation for acute decompensated heart failure as the primary reason for admission or a cardiovascular death.
There were 126 867 and 79 192 new users of metformin and sulfonylurea, respectively. Propensity score matching yielded 65 986 per group. Median age was 66 years, and 97 per cent of patients were male; hemoglobin A1c 6.9 per cent (6.3, 7.7); body mass index 30.7 kg/m2 (27.4, 34.6); and 6 per cent had heart failure history.
There were 1,236 events (1,184 heart failure hospitalisations and 52 cardiovascular deaths) among sulfonylurea takers and 1,078 events (1,043 heart failure hospitalizations and 35 cardiovascular deaths) among metformin initiators. There were 12.4 versus 8.9 events per 1000 person‐years of use (adjusted hazard ratio 1.32, 95 per centCI 1.21, 1.43).
The rate difference was four heart failure hospitalisations or cardiovascular deaths per 1,000 users of sulfonylureas versus metformin annually.
The findings have been published in the Journal of the American Heart Association (JAMA).