The cardiovascular effects of the thiazolidinediones: a review of the clinical data

Aaron S Kelly, Alan J. Bank

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Beyond glycemic control, the thiazolidinediones (TZDs) provide numerous cardiovascular benefits. Clinical data support a role for the TZDs in lowering blood pressure, correcting dyslipidemia, improving vascular structure and function, decreasing inflammation, improving the adipokine profile, reducing systemic oxidative stress, and possibly in stabilizing coronary plaques that may be prone to rupture. Data from the first outcomes trial assessing a TZD in reducing cardiovascular morbidity and mortality have recently been reported. Results were promising, but not conclusive. Therefore, other large studies currently underway should provide greater insight into the role of the TZDs in modifying cardiovascular risk in patients with type 2 diabetes. Reported side effects of the TZDs include fluid retention, worsening of heart failure, and weight gain. Recent research is beginning to clarify the mechanisms associated with these potential side effects and may result in the expanded use of this drug class in patients with heart failure. Because of the unique mechanism of action of this drug class that addresses a fundamental pathophysiolgical phenomenon in type 2 diabetes, namely, improving insulin resistance, and the growing body of evidence supporting cardiovascular benefits, strong consideration should be given to utilizing the TZDs early in the clinical course of diabetes.

Original languageEnglish (US)
Pages (from-to)326-334
Number of pages9
JournalJournal of Diabetes and Its Complications
Volume21
Issue number5
DOIs
StatePublished - Sep 1 2007

Fingerprint

Thiazolidinediones
Type 2 Diabetes Mellitus
Heart Failure
Adipokines
Dyslipidemias
Pharmaceutical Preparations
Weight Gain
Blood Vessels
Insulin Resistance
Rupture
Oxidative Stress
Blood Pressure
Inflammation
Morbidity
Mortality
Research

Keywords

  • Cardiovascular disease
  • Thiazolidinediones
  • Type 2 diabetes

Cite this

The cardiovascular effects of the thiazolidinediones : a review of the clinical data. / Kelly, Aaron S; Bank, Alan J.

In: Journal of Diabetes and Its Complications, Vol. 21, No. 5, 01.09.2007, p. 326-334.

Research output: Contribution to journalArticle

@article{dcba36469b5a454bb1cde06725b44e06,
title = "The cardiovascular effects of the thiazolidinediones: a review of the clinical data",
abstract = "Beyond glycemic control, the thiazolidinediones (TZDs) provide numerous cardiovascular benefits. Clinical data support a role for the TZDs in lowering blood pressure, correcting dyslipidemia, improving vascular structure and function, decreasing inflammation, improving the adipokine profile, reducing systemic oxidative stress, and possibly in stabilizing coronary plaques that may be prone to rupture. Data from the first outcomes trial assessing a TZD in reducing cardiovascular morbidity and mortality have recently been reported. Results were promising, but not conclusive. Therefore, other large studies currently underway should provide greater insight into the role of the TZDs in modifying cardiovascular risk in patients with type 2 diabetes. Reported side effects of the TZDs include fluid retention, worsening of heart failure, and weight gain. Recent research is beginning to clarify the mechanisms associated with these potential side effects and may result in the expanded use of this drug class in patients with heart failure. Because of the unique mechanism of action of this drug class that addresses a fundamental pathophysiolgical phenomenon in type 2 diabetes, namely, improving insulin resistance, and the growing body of evidence supporting cardiovascular benefits, strong consideration should be given to utilizing the TZDs early in the clinical course of diabetes.",
keywords = "Cardiovascular disease, Thiazolidinediones, Type 2 diabetes",
author = "Kelly, {Aaron S} and Bank, {Alan J.}",
year = "2007",
month = "9",
day = "1",
doi = "10.1016/j.jdiacomp.2006.03.006",
language = "English (US)",
volume = "21",
pages = "326--334",
journal = "Journal of Diabetes and its Complications",
issn = "1056-8727",
publisher = "Elsevier Inc.",
number = "5",

}

TY - JOUR

T1 - The cardiovascular effects of the thiazolidinediones

T2 - a review of the clinical data

AU - Kelly, Aaron S

AU - Bank, Alan J.

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Beyond glycemic control, the thiazolidinediones (TZDs) provide numerous cardiovascular benefits. Clinical data support a role for the TZDs in lowering blood pressure, correcting dyslipidemia, improving vascular structure and function, decreasing inflammation, improving the adipokine profile, reducing systemic oxidative stress, and possibly in stabilizing coronary plaques that may be prone to rupture. Data from the first outcomes trial assessing a TZD in reducing cardiovascular morbidity and mortality have recently been reported. Results were promising, but not conclusive. Therefore, other large studies currently underway should provide greater insight into the role of the TZDs in modifying cardiovascular risk in patients with type 2 diabetes. Reported side effects of the TZDs include fluid retention, worsening of heart failure, and weight gain. Recent research is beginning to clarify the mechanisms associated with these potential side effects and may result in the expanded use of this drug class in patients with heart failure. Because of the unique mechanism of action of this drug class that addresses a fundamental pathophysiolgical phenomenon in type 2 diabetes, namely, improving insulin resistance, and the growing body of evidence supporting cardiovascular benefits, strong consideration should be given to utilizing the TZDs early in the clinical course of diabetes.

AB - Beyond glycemic control, the thiazolidinediones (TZDs) provide numerous cardiovascular benefits. Clinical data support a role for the TZDs in lowering blood pressure, correcting dyslipidemia, improving vascular structure and function, decreasing inflammation, improving the adipokine profile, reducing systemic oxidative stress, and possibly in stabilizing coronary plaques that may be prone to rupture. Data from the first outcomes trial assessing a TZD in reducing cardiovascular morbidity and mortality have recently been reported. Results were promising, but not conclusive. Therefore, other large studies currently underway should provide greater insight into the role of the TZDs in modifying cardiovascular risk in patients with type 2 diabetes. Reported side effects of the TZDs include fluid retention, worsening of heart failure, and weight gain. Recent research is beginning to clarify the mechanisms associated with these potential side effects and may result in the expanded use of this drug class in patients with heart failure. Because of the unique mechanism of action of this drug class that addresses a fundamental pathophysiolgical phenomenon in type 2 diabetes, namely, improving insulin resistance, and the growing body of evidence supporting cardiovascular benefits, strong consideration should be given to utilizing the TZDs early in the clinical course of diabetes.

KW - Cardiovascular disease

KW - Thiazolidinediones

KW - Type 2 diabetes

UR - http://www.scopus.com/inward/record.url?scp=34548297729&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548297729&partnerID=8YFLogxK

U2 - 10.1016/j.jdiacomp.2006.03.006

DO - 10.1016/j.jdiacomp.2006.03.006

M3 - Article

C2 - 17825758

AN - SCOPUS:34548297729

VL - 21

SP - 326

EP - 334

JO - Journal of Diabetes and its Complications

JF - Journal of Diabetes and its Complications

SN - 1056-8727

IS - 5

ER -