Medical Research: What are the main findings of the study?
Dr. Hu: in this study among approximately 5000 patients with type 2 diabetes followed for up to 10 years, longer duration of sulfonylurea therapy was associated with a higher risk of coronary heart disease. The continuous sulfonylurea therapy for 10 years was associated with almost two times greater risk of coronary heart disease compared with nonusers. However, given the observational nature of the study, we cannot make causal inference from these findings.
Medical Research: Were any of the findings unexpected?
Dr. Hu: Drug treatment labels for Sulfonylurea medications have a black box warning for cardiovascular risk. Based on previous studies, our study hypothesis was that sulfonylurea use would be associated with increased cardiovascular risk, thus the study findings supported this hypothesis. The potential mechanism of sulfonylurea’s impact on cardiovascular disease is its effect on myocardial KATP channels that may interfere the cellular pathway that confers myocardial ischemic protection.
Medical Research: What should clinicians and patients take away from your report?
Dr. Hu: We suggest the clinicians consider these findings, along with other available studies, when managing patients with diabetes, especially those who are at high risk of cardiovascular disease.
Medical Research: What recommendations do you have for future research as a result of this study?
Dr. Hu: Future prospective studies of sulfonylurea and cardiovascular risk are warranted to confirm this finding and possibly in other populations. In addition, further evaluation of different sulfonylurea medications and doses will be important.
Sulfonylurea Use and Incident Cardiovascular Disease Among Patients With Type 2 Diabetes: Prospective Cohort Study Among Women
Yanping Li, Yang Hu, Sylvia H. Ley, Swapnil Rajpathak, and Frank B. Hu
Diabetes Care published ahead of print August 22, 2014, doi:10.2337/dc14-1306 1935-5548