Diabetes drug linked to higher heart attack risk

Avandia and competitor drug, Actos, are commonly used diabetes drugs. Avandia has been found having harmful effects since 2007 while Actos seems safer apparently.

2 studies published last week reported serious health warnings. One study, published in June 28 issue of JAMA, reviewed the data of 227,000 patients takng either Avandia or Actos, found that Avandia increased the risk of heart attack, stroke or death by 17%.

The second study, published in the Archive of Internal Medicine, analysed 56 clinical trials involving 35,000 patients confirmed these findings. The reserachers questioned why Avandia is still available on the market and why physicians would prescribe it to diabetics when there are other drugs without these side effects. They called for Avandia to be withdrawn from the market.

However, some doctors said that the evidence is inconclusive.

Source:
1). David Juurlink. "Rosiglitazone and the Case for Safety Over Certainty". JAMA. 2010;304(4):(doi:10.1001/jama.2010.954). free f/t

2). Steven Nissen; Kathy Wolski. "An Updated Meta-analysis of Risk for Myocardial Infarction and Cardiovascular Mortality". Arch Intern Med. 2010;170(14), free f/t

Are HRT patches safer than pills?

A large study including 75,000 women suggests that low-dose HRT patches may be safer than tablets in terms of stroke risk, but the risk increases significantly with high dose patches.

The findings are based on a nested case-control study drawing data from the General Practice Research Database in the UK. Researchers compare a group of women who have stroke ( case group) to a group who do not ( control group) and found that women using low-dose HRT patches had no increased risk of stroke compared with those who had not used HRT patches, however, using high-dose patches had an increased risk of 89% compared with non-use.

Researchers concluded that low-dose HRT patches may be a safer alternative to oral HRT, although these results alone cannot prove causation, "this study should encourage further research on the importance of the route of administration to define the role of transdermal oestrogens in the therapeutic arsenal for the treatment of menopausal symptoms."

Critics say that this study could affect prescribing practice but it only looked at stroke risk while HRT is assocaited with other risks such as breast cancer, venous thromboembolism and heart disease. The study was published in the BMJ.

Source: Renoux C, Dell’Aniello S, Garbe E and Suissa S. Transdermal and oral hormone replacement therapy and the risk of stroke: a nested case-control study. BMJ 2010;340:c2519, (Published June 3 2010) full text via Athens

Processed meat increased heart disease risk

A new systematic review and meta-analysis of 20 studies involving more than 1.2 millions people from 10 countries found that processed meat such as bacon, salami, sausages, hot dogs and processed deli, was linked to increased risk of heart disease and diabetes, but red meat was not.

Participants were followed up to 18 years and found that those who ate 50 gram a day of processed red meat had 42% higher risk of heart disease and 19% higher risk of type 2 diabetes than those who did not eat processed red meat.

Researchers said that the processed meat contain much higher salt and preservatives ( rather than fats) than unprocessed meat and this could explain the difference. They found the same even when lifestyle factors were taken into account and suggested that these types of meats should be studied separately in future research.

Source: "Red and Processed Meat Consumption and Risk of Incident Coronary Heart Disease, Stroke, and Diabetes Mellitus. A Systematic Review and Meta-Analysis". Circulation. 2010 Published online before print May 17, 2010 ( f/t via Athens)

Brisk walking can reduce stroke risk in women

A large study published in Stroke found that women who walked two or more hours a week or walked briskly lowered the risk of stroke by more than a third.


The researchers followed nearly 40000 women aged over 44 for about 12 years to investigate the link between the levels of physical actitivity and the risk of having a stroke. The participants reported periodically on their physical activities via a questionnaire. 579 women had a stroke during the follow-up years.


The researchers said they have found a borderline significant link between the time spent on physical activities and stroke risk but they did not find a link between vigorous activity and reduced stroke risk. The lead author said the study was observational and physical activity was self-reported, further study is needed on more hemorrhagic strokes and with more ethnically diverse women.

Source: "Physical Activity and Risk of Stroke in Women". Stroke, published online April 2010 DOI