Diabetes and heart disease are two major health problems, resulting in just under 700,000 deaths a year in the U.S. alone, and a particular class of diabetes drugs showed promise for treating both diseases at once. However, a new study has found that despite this promise, a particular diabetes drug did not actually reduce the risk of heart failure.
The study comes from Kenneth B. Margulies, M.D., and other researchers at the University of Pennsylvania, Philadelphia. The researchers published their results in the August 2nd issue of the journal JAMA. Other clinical studies had suggested that a class of diabetes drugs, called glucagon-like peptide 1 agonists (GLP-1 agonists), seemed to help the heart, so the current research delved into if these drugs really can help advanced heart failure patients.
To investigate this, the researchers recruited 300 patients who were recently hospitalized with advanced heart failure and reduced left ventricular ejection fraction (LVEF), which is a measure of how much blood the heart pumps. About half of the patients received liraglutide, a GLP-1 agonist drug, and about half received a placebo. The researchers gradually increased the dosage of the drug for 30 days, then continued the treatment for the next six months. At the end of the study, the researchers gave the patients a ranking from low to high stability, based on the time to death, time to rehospitalization for heart failure, and change in peptide levels. A high value indicated the patient had better heart health.
When the study completed, twelve percent of patients in the liraglutide group had died, and 11 percent of patients in the placebo group had died, which was not a significant difference between the two groups. In the liraglutide group, 41 percent of patients were rehospitalized for heart failure, and 34 percent of the placebo group were rehospitalized for heart failure, which was also not a significant difference. Not only that, the two groups did not seem to be different in their cardiac function, physical activity, and quality of life. In summary, taking the diabetes drug did not seem to improve heart health in these patients.
The researchers found similar results even when they compared diabetes patients to those who did not have diabetes. Although the liraglutide could help the patients manage their diabetes, controlling blood sugar and helping promote weight loss, the drug did not seem to help their heart health. It was a disappointing finding for a drug that had showed so much promise for improving heart health.
Having diabetes can increase the risk of heart failure, so theoretically treating the diabetes can lower the risk of heart failure. As blood sugar increases with diabetes, it can damage nerves and blood vessels, allowing fat to deposit within arteries, triggering heart disease. Statistically, someone with diabetes is about twice as likely as someone without diabetes to have heart disease or stroke, and heart attacks can also be more deadly for diabetics.
Although the current study failed to show an improvement in heart health when patients took liraglutide, the researchers encourage further study. It is possible that although liraglutide did not help patients in the study with advanced heart failure, the diabetes drug may be able to help patients with earlier stages of heart failure. It is possible that helping to control blood sugar and weight early enough with this drug can still reduce the risk of heart failure later.
Despite the disappointing results for GLP-1 agonists, there are other things people can do to reduce their risk of heart disease. Quitting smoking is one of the best ways to improve heart health, along with maintaining a healthy diet, healthy weight, and healthy fitness levels. Experts recommend eating foods containing fiber daily to help lower cholesterol, and cutting down on foods with saturated fat, trans fat, and cholesterol. Doctors may also prescribe cholesterol drugs or recommend daily aspirin to help reduce the chance of heart failure.