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Long-term sulphonylurea use and risk of CHD in women with T2D

This analysis was part of the long-term follow-up of the Nurses’ Health Study (NHS), a well-established observational cohort study of American women. In all, 4902 women with diabetes (mean duration, 11 years) but who did not have cardiovascular disease at baseline were observed and had their medication use recorded. A longer duration of sulphonylurea use was significantly associated with a higher risk of coronary heart disease compared with non-use, both in people also on metformin therapy and those not on this background therapy.

by Colin Kenny, GP, Dromore

Since it started in 1976, the Nurses’ Health Study has supplied important data on the risk of cancer, cardiovascular disease and diabetes. For this particular analysis, a cohort of 4902 women with diabetes were followed up. Information was recorded on their use of diabetes drugs. The use of sulphonylureas and other medications was self-reported at baseline and during the follow-up period of up to 10 years. Potential confounding factors such as age, diabetes duration, diabetes-related complications, other antidiabetes medications, BMI, lifestyle factors and family history of cardiovascular diseases were allowed for.

During the period of follow-up, there were 339 incident cases of cardiovascular disease, including 191 cases of coronary heart disease and 148 instances of stroke. Sulphonylurea use for over 10 years’ duration was significantly associated with a higher risk of coronary heart disease compared with non-use. Sulphonylurea use was also associated with a higher risk when added to metformin. There was not a significant association between sulphonylurea use and stroke risk. Although randomised trials such as UKPDS and ADVANCE have not confirmed this association, it nonetheless raises concerns about long-term sulphonylurea use in women.

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