In the Journals

Long-term use of sulfonylureas linked to CHD in women with diabetes

A higher risk of coronary heart disease is associated with long-term use of sulfonylureas among women with diabetes, according to recent study findings published in Diabetes Care.

In the study, researchers evaluated 4,902 women with type 2 diabetes who responded to a supplemental questionnaire in 2000 and 2005 as part of the Nurses’ Health Study cohort to determine the association between sulfonylurea use and the risk of cardiovascular disease. The study’s follow-up extended to June 30, 2010. At baseline and throughout the study period, participants self-reported on their use of sulfonylureas and other medications.

The researchers found that 339 incident cases occurred during the course of the study; these consisted of 191 cases of coronary heart disease (CHD) and 148 strokes.

The risk of CHD was significantly higher with longer duration of sulfonylurea use (P=.002). Compared with nonusers, participants who used sulfonylureas for 1 to 5 years had RRs for CHD of 1.24 (95% CI, 0.85-1.81), while those who used sulfonylureas for 6 to 10 years had RRs of 1.51 (95% CI, 0.94-2.32), and those who used sulfonylureas for >10 years had RRs of 2.15 (95% CI, 1.31-3.54).

A combination of metformin and sulfonylurea had an RR for CHD of 3.28 (1.31-8.17) compared to metformin monotherapy. 

No significant association was found between the use of sulfonylureas and stroke risk.

“In conclusion, our study suggest that a longer duration of sulfonylurea therapy was associated with a higher risk of CHD, and the combination therapy of metformin and sulfonylurea was associated with an increased CHD risk compared with metformin monotherapy or sulfonylurea monotherapy,” the researchers wrote. “Further prospective studies are warranted to replicate our findings.”

Disclosure: The study was partly funded by Merck. Two researchers report financial ties with Merck.

A higher risk of coronary heart disease is associated with long-term use of sulfonylureas among women with diabetes, according to recent study findings published in Diabetes Care.

In the study, researchers evaluated 4,902 women with type 2 diabetes who responded to a supplemental questionnaire in 2000 and 2005 as part of the Nurses’ Health Study cohort to determine the association between sulfonylurea use and the risk of cardiovascular disease. The study’s follow-up extended to June 30, 2010. At baseline and throughout the study period, participants self-reported on their use of sulfonylureas and other medications.

The researchers found that 339 incident cases occurred during the course of the study; these consisted of 191 cases of coronary heart disease (CHD) and 148 strokes.

The risk of CHD was significantly higher with longer duration of sulfonylurea use (P=.002). Compared with nonusers, participants who used sulfonylureas for 1 to 5 years had RRs for CHD of 1.24 (95% CI, 0.85-1.81), while those who used sulfonylureas for 6 to 10 years had RRs of 1.51 (95% CI, 0.94-2.32), and those who used sulfonylureas for >10 years had RRs of 2.15 (95% CI, 1.31-3.54).

A combination of metformin and sulfonylurea had an RR for CHD of 3.28 (1.31-8.17) compared to metformin monotherapy. 

No significant association was found between the use of sulfonylureas and stroke risk.

“In conclusion, our study suggest that a longer duration of sulfonylurea therapy was associated with a higher risk of CHD, and the combination therapy of metformin and sulfonylurea was associated with an increased CHD risk compared with metformin monotherapy or sulfonylurea monotherapy,” the researchers wrote. “Further prospective studies are warranted to replicate our findings.”

Disclosure: The study was partly funded by Merck. Two researchers report financial ties with Merck.