Sulfonylureas Cause Heart Trouble

[Guest guest]

Here's a post to our group from Dave O., dated March 11th:

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Ran across this cite from a wise member at mhd:

Am Coll Cardiol 1998 Apr;31(5):950-6

The sulfonylurea controversy: more questions from the heart.

Brady PA, Terzic A

Department of Medicine, Mayo Clinic, Mayo Foundation, Rochester, Minnesota

55905, USA.

Myocardial ischemia and infarction are associated with substantially

increased morbidity and mortality among patients with diabetes mellitus.

Although many factors contribute to the increased morbidity and mortality,

in patients with non-insulin-dependent (type II) diabetes mellitus, one

contributor may be the use of sulfonylurea drugs, the most widely used oral

hypoglycemic agents. Such a possibility, which first arose over a

25 years ago when it was observed that patients taking sulfonylurea drugs

had increased cardiovascular mortality, has recently resurfaced after the

discovery that sulfonylureas act by inhibiting adenosine triphosphate

(ATP)-sensitive potassium channels. In the pancreas, inhibition of

ATP-sensitive potassium channels induces release of insulin; but in the

heart, inhibition of these channels prevents ischemic preconditioning, an

endogenous cardioprotective mechanism that protects the heart from lethal

injury. This review outlines the current understanding of the molecular and

cellular pharmacodynamics of sulfonylurea drugs and discusses the potential

clinical consequences of inhibition of ATP-sensitive potassium

channels in the heart of diabetic patients with cardiac disease in whom the

use of sulfonylureas may be harmful.