Diabetes Medication (Actos) and Heart Failure

This article is a guest post from Drug Watch. DrugWatch is an online resource which details accurate and up-to-date information on prescription and over-the-counter medications and their associated side effects. 

This article discusses the side effects of the diabetes drug Actos.

Doctors prescribe Actos (pioglitazone) to diabetes patients to control their blood sugar. Mostly used by type 2 diabetes patients, Actos reduces blood sugar by increasing the sensitivity of cells to insulin and slowing sugar production by the liver.

However, the risk for Congestive Heart Failure (CHF) is increased by 30 percent for users of Actos. Type 1 and type 2 diabetes patients are already at risk for heart disease and high blood pressure, which may cause CHF.

When the heart does not properly pump blood to the rest of the body, people develop CHF. As fluid that should be pumped by the heart builds up in the lungs, liver, gastrointestinal tract, arms and legs, patients may require preventative medicines or surgery, including a heart transplant.

One trial of more than 5,000 patients found a large percentage of patients suffered a serious heart failure event while taking Actos. 

Germany and France have reacted to studies on Actos by banning its use.

The label on the Actos box recommends that patients with the New York Heart Association Class III or IV heart failure should not use the medication. The box also warns that Actos may cause or exacerbate CHF.  Heart problems make up just one of the side effects of Actos.

Additionally, Actos use has led to bone fractures, liver problems and various types of edema. One type is known as macular edema, which occurs when there is swelling in the retina that causes blurred vision and a decreased ability to distinguish colors.

Edema, or swelling, that occurs in other parts of the body can contribute to CHF.

Numerous lawsuits by Actos userswho have developed bladder cancer — where tumors may progress to stage III, leaving only a 50 percent chance of survival — have been filed.

Symptoms indicating CHF are fatigue, loss of appetite, weakness, cough, need to urinate at night, fast or irregular pulse, weight gain, shortness of breath and swollen liver, abdomen, feet or ankles.

Patients with these symptoms should talk to their doctor right away. Patients should always discuss the risks of medication with their doctor before taking a new prescription. Together, patients and doctors can decide which medication is the right choice.

Alanna Ritchie is a writer for Drugwatch.com. An English major, she is an accomplished technical and creative writer.

Sources:
“Pioglitazone and risk of cardiovascular events in patients with type-2 diabetes mellitus” http://jama.ama-assn.org/content/298/10/1180

Singh, S, et al. (2007). Thiazolidinediones and Heart Failure: A Teleo-Analysis. Diabetes Care. Retrieved from http://care.diabetesjournals.org/content/early/2007/05/29/dc07-0141.abstract

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Increasing saturated fat consumption is associated with a decrease in death rates from heart disease

This study was published in the Journal of Clinical Epidemiology 1996 Feb;49(2):211-6

Study title and authors:
Relationship between dietary intake and coronary heart disease mortality: lipid research clinics prevalence follow-up study.

Esrey KL, Joseph L, Grover SA.
Centre For the Analysis of Cost-Effective Care, Montreal General Hospital, Quebec, Canada.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8606322

This study examined the relationship between dietary intake and death from heart disease. The study included 4,546 men, aged 30 to 79, who were followed for 12 years.

Regarding dietary saturated fat, the study found that increasing consumption of saturated fat was associated with a 3% decrease in death rates from heart disease.

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Heart attack survivors live longer if they have high cholesterol

This study was published in the Journal of the American Geriatrics Society 2003 Jul;51(7):930-6

Study title and authors:

Long-term prognostic importance of total cholesterol in elderly survivors of an acute myocardial infarction: the Cooperative Cardiovascular Pilot Project.

Foody JM, Wang Y, Kiefe CI, Ellerbeck EF, Gold J, Radford MJ, Krumholz HM.

Section of Cardiovascular Medicine, Department of Medicine, Yale School of Medicine, New Haven, Connecticut, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/12834512

This study sought to determine the relationship of cholesterol levels to long-term survival rates in elderly survivors of a heart attack. The study analysed the death rates of 4,923 heart attack patients aged 65 and older for six years.

The study found:
(a) After one year those with the lowest cholesterol levels (less than 160 mg/dL or 4.1 mmol/l) had 5% more deaths than those with the highest cholesterol (above 240 mg/dL or 6.2 mmol/l).
(b) After six years those with the lowest cholesterol levels (less than 160 mg/dL or 4.1 mmol/l) had 7.6% more deaths than those with the highest cholesterol (above 240 mg/dL or 6.2 mmol/l).

The results of the study show that heart attack survivors live longer if they have high cholesterol.

Links to other studies:
Men who stop smoking AND lower their cholesterol levels have a 2% increase in their death rates
Low cholesterol and increased mortality in men and women
A rise in total cholesterol reduces the risk of mortality in the oldest old

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20 year study shows that a high saturated fat diet is associated with a reduction in heart disease

This study was published in the American Journal of Epidemiology 2005 Apr 1;161(7):672-9

Study title and authors:

Dietary fat intake and risk of coronary heart disease in women: 20 years of follow-up of the nurses' health study.

Oh K, Hu FB, Manson JE, Stampfer MJ, Willett WC.

Department of Nutrition, Harvard School of Public Health, Boston, MA 02115, USA.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/15781956

This study examined the associations of dietary fat with the risk of coronary heart disease. The study included 78,778 women who were followed for 20 years.

Regarding saturated fat, the study found that women who consumed the most saturated fat had a 3% reduced risk of heart disease compared to the women who consumed the least saturated fat.

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High saturated fat diet reduces the risk of developing cardiovascular diseases

This study was published in PLoS One 2012;7(2):e31637

Study title and authors:

Dietary fiber and saturated fat intake associations with cardiovascular disease differ by sex in the Malmö Diet and Cancer Cohort: a prospective study.

Wallström P, Sonestedt E, Hlebowicz J, Ericson U, Drake I, Persson M, Gullberg B, Hedblad B, Wirfält E.

Nutrition Epidemiology Research Group, Department of Clinical Sciences, Lund University, Malmö, Sweden. peter.wallstrom@med.lu.se

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/22384046

This study investigated the association between nutrient intake and the risk of cardiovascular disease. The study included 8,139 male and 12,535 female participants, aged 44 to 73, who were followed for an average of 13.5 years.

The study found:
(a) Men who consumed the most dietary fat had a 5% reduced risk of cardiovascular disease compared to men who consumed the least dietary fat.
(b) Women who consumed the most dietary fat had a 14% reduced risk of cardiovascular disease compared to women who consumed the least dietary fat.
(c) Men who consumed the most saturated fat had an 11% reduced risk of cardiovascular disease compared to men who consumed the least saturated fat.
(d) Women who consumed the most saturated fat had an 13% reduced risk of cardiovascular disease compared to women who consumed the least saturated fat.
(e) Men who consumed the most carbohydrate had a 9% increased risk of cardiovascular disease compared to men who consumed the least carbohydrate.
(f) Women who consumed the most carbohydrate had an 18% increased risk of cardiovascular disease compared to women who consumed the least carbohydrate.

The data from the study shows that a high saturated fat diet reduces the risk of developing cardiovascular diseases.

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My book now available on kindle

At long last my book Cholesterol and Saturated Fat Prevent Heart Disease is now available on kindle.



Kindle US here
Kindle UK here
Kindle France here
Kindle Germany here
Kindle Italy here

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23 year study shows a high saturated fat diet is associated with a 14% decrease in deaths from heart disease

This study was published in Cardiology 1993;82(2-3):100-21

Study title and authors:

Factors predictive of long-term coronary heart disease mortality among 10,059 male Israeli civil servants and municipal employees. A 23-year mortality follow-up in the Israeli Ischemic Heart Disease Study.

Goldbourt U, Yaari S, Medalie JH.

Department of Epidemiology and Preventive Medicine, Sackler School of Medicine, Tel Aviv University, Israel.

This study can be accessed at: http://www.ncbi.nlm.nih.gov/pubmed/8324774

This study investigated factors that caused coronary heart disease death. The study included 10,059 men, aged 40 and over, who were followed for 23 years.

Regarding saturated fat, the study found that the men who consumed the most saturated fat had a 14% decreased risk of death from heart disease compared to the men who consumed the least saturated fat.

Read more ►