The Impact of Cardiovascular Drugs on Glycemic Control: A Review

Abstract

Introduction The prevalence of diabetes is steadily rising in the US, both in the general population and among those with cardiovascular disease (CVD). Understanding how to treat a patient with both conditions is becoming increasingly important. With multiple therapeutic options for CVD management, some medications will invariably impact glycemia in this group of patients. The concept of “DM-friendly” management of CVD is based on a treatment approach of selecting medications that do not impair glycemic control, provided equivalent cardioprotective effects. This article reviews the glycemic effects of various classes of medications commonly used to treat CVD. Methods Data sources were all PubMed and Google Scholar-referenced articles in English-language peer-reviewed journals from 1980 to the present. Studies selected could include observational studies or prospective clinical trials. Prospective clinical trials included in this review focused on investigating the association of the medication of interest with glycemic outcomes. Meta-analyses and systematic reviews were also included. Results The data on glycemic effects was lacking for many of the medication classes and individual medications examined. However, in our review, certain beta-blockers and renin angiotensin aldosterone system inhibitor (RAAS-i) agents, and select CCBs were consistently shown to have favorable glycometabolic profiles when compared with other commonly used cardiovascular therapies. Conclusions Several commonly prescribed medications for the treatment of cardiovascular disease, such as certain beta-blockers, RAAS agents, and ranolazine, are associated with favorable glycometabolic effects. As clinicians are more often faced with the challenge of treating patients with diabetes and concomitant cardiovascular disease, consideration of how common cardiovascular medications may affect glycemia should be incorporated into the clinical decision making process.

Time-Trends of Drug-Drug Interactions among Elderly Outpatients in the Piedmont Region (Italy): A Population-Based Study

“…During the study period, two DDIs showed a slightly increase, namely antidiabetics and beta-blocking agents and clopidogrel and PPIs. As for the DDI involving antidiabetics and beta-blocking agents, this may provide an example of two drugs deliberately and unavoidably prescribed together [ 33 ]. In the Italian population, beta-blocking agents represent one the most frequently prescribed drug classes, with a prevalence of use of around 25% in patients between 65 and 74 years and an even higher one among those older than 85 years (about 40%) [ 27 ].…”

Цукровий Діабет І Хронічний Коронарний Синдром

“…До недавнього часу основними показаннями до призначення іАПФ були СН, АГ і ЦД, в першу чергу за наявності супутньої АГ або мікроальбумінурії. Ефективність іАПФ у хворих із ХКС із метою вторинної профілактики вивчали в наступних дослідженнях [52,53]: HOPE -пацієнти з ІХС або ЦД і високим ризиком розвитку серцево-судинних ускладнень, але без СН (10 мг/ добу, тривалість 5 років); EUROPA -хворі на ХКС різного за ступенем ризику, без клінічних ознак СН (периндоприл 8 мг/добу, тривалість дослідження -4,2 року); PEACE -пацієнти з ХКС без СН (трандолаприл 2-4 мг/добу, тривалість 4,8 року). НОРЕ і EUROPA продемонстрували зниження серцево-судинного ризику (кардіальна смерть, нефатальний ІМ) на 26 і 20 % відповідно.…”

“…Огляд літератури /Literature Review/ воджувалося істотним (до 32 %) зменшенням кількості випадків розвитку інсульту [52][53][54].…”