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...

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Bibliographic Details
Published in:Journal of diabetes and its complications 2007-09, Vol.21 (5), p.326-334
Main Authors: Kelly, Aaron S, Bank, Alan J
Format: Article
Language:English
Subjects:
Antihypertensive Agents - pharmacology
Blood Pressure - drug effects
Cardiovascular disease
Cardiovascular Physiological Phenomena - drug effects
Carotid Arteries - drug effects
Carotid Arteries - physiology
Carotid Arteries - physiopathology
Cholesterol
Cytokines - physiology
Diabetes
Endocrinology & Metabolism
Endothelium, Vascular - drug effects
Endothelium, Vascular - physiology
Endothelium, Vascular - physiopathology
Humans
Inflammation - physiopathology
Insulin
Insulin resistance
Lipids
Studies
Thiazolidinediones
Thiazolidinediones - pharmacology
Thiazolidinediones - therapeutic use
Type 2 diabetes
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Summary: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.
ISSN:1056-8727
1873-460X
DOI:10.1016/j.jdiacomp.2006.03.006