Background: Cardiovascular disease is the leading cause of morbidity and mortality among patients with diabetes, underscoring the importance of choosing drugs that do not increase cardiovascular risk and reduce the risk of cardiovascular events. Since 2008, the US Food and Drug Administration has recommended that new drugs for type 2 diabetes undergo clinical trials to demonstrate cardiovascular safety in addition to glycemic benefit. In 2012, the European Medicines Agency issued a similar recommendation.
Methods: We searched the PubMed, Cochrane CENTRAL, EMBASE, and CINAHL databases from inception through August 2013 and compiled and reviewed the existing data on the cardiovascular safety profiles of currently available diabetic drugs.
Results: While intensive glycemic control in diabetics has been consistently shown to reduce the risk of microvascular complications, the data on macrovascular risk reduction have not been as clear, and questions have been raised about possible increases in cardiovascular morbidity and mortality.
Conclusion: Careful selection of drug therapy-paying particular attention to cardiovascular safety-is important in optimizing diabetic therapy.
Keywords: Acarbose; biguanides; cardiovascular diseases; diabetes mellitus; dipeptidyl-peptidase 4 inhibitors; drug therapy; dyslipidemias; hypertension; incretins; sulfonylurea compounds.