(This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays.)
By Nancy Lapid
Nov 4 (Reuters) – Today we feature a trio of interesting studies that will be presented in detail at the American Heart Association scientific sessions in Chicago this weekend.
GLP-1 DRUGS MAY OUTPERFORM METFORMIN FOR PREDIABETES
GLP-1 drugs may help prevent type 2 diabetes and lower the risk of heart attack and stroke in people diagnosed with prediabetes more effectively than the current standard medication, according to data to be reported at the AHA meeting.
Researchers reviewed medical records of more than 256,000 adults with prediabetes and obesity, about half of whom were taking the GLP-1 medications semaglutide, tirzepatide, liraglutide or dulaglutide. Semaglutide and liraglutide are Novo Nordisk diabetes drugs sold as Ozempic and Victoza, respectively. Eli Lilly’s tirzepatide and dulaglutide are sold under the brand names Mounjaro and Trulicity for diabetes.
The other half were taking metformin, a gold-standard generic medication prescribed for prediabetes.
During the three-year study period, patients taking GLP-1s had a 50% higher chance of reversing high blood sugar to normal levels, a 31% lower risk of developing full-blown type 2 diabetes, and a 41% lower risk of death from any cause, compared to patients taking metformin.
GLP-1 medications were also associated with 15% fewer heart attacks, 20% fewer strokes, 25% fewer cases of heart failure and 8% fewer cases of the irregular heartbeat known as atrial fibrillation that can increase stroke risk fivefold, according to a brief summary, or abstract, of the study.
“This research may add to the case for considering GLP-1 medications earlier for certain patients, rather than waiting until they develop type 2 diabetes,” study leader Dr. Vinicius de Sousa Barzon Serra of the Mayo Clinic in Scottsdale, Arizona, said in a statement.
The benefits are likely related to weight loss, which is known to help prevent type 2 diabetes, Dr. Robert Eckel, a past president of the American Heart Association who wasn’t involved in the study, said in a statement.
Metformin is still a first-line treatment choice that’s safe, inexpensive and has a long track record, Serra said.
HORMONE THERAPY BEFORE AGE 60 IS SAFE FOR HEART HEALTH
Modern hormone replacement regimens are not associated with an increased risk for heart attack, stroke, blood clots or death, according to long-term data from a large study.
The study involved 52,330 women ages 45–59 — half of whom were on hormone replacement therapy — who were followed for an average of 12 years.
The combined rate of heart attack, stroke or some other type of heart disease was 4.4% in the HRT group and 4.6% for the control group, who were closely matched in terms of age and other risk factors.
“Concerns that hormone replacement therapy may affect the heart is one of the most common reasons women decline hormone therapy to manage menopause symptoms, and why some healthcare professionals may hesitate to offer it,” study leader Ronen Arbel of Clalit Health Services in Tel Aviv said in a statement.
Fears that HRT is linked with cardiovascular harm arose mainly from studies with older therapy formulations that are no longer commonly used, with higher doses and in women who started on HRT long after menopause.
The American College of Obstetricians and Gynecologists now recommends starting HRT within 10 years of menopause onset and before age 60.
In other data from the study to be presented at the AHA meeting, death before age 80 occurred in 1.3% of women taking HRT and in 1.2% of non-users.
Blood clots occurred in 0.33% of women in both groups.
The results were similar across all HRT formulations regardless of whether the hormones were administered orally or via a patch or gel.
While observational studies cannot prove safety, these findings add to growing evidence that today’s hormone therapy options may not increase the risk of heart disease, stroke or blood clots for healthy women who begin treatment around the time of menopause, Dr. Stacey Rosen of Northwell Health in New York, a past president of the AHA, said in a statement.
CANNABIS LINKED WITH HEART DISEASE IN LARGE SURVEY
Cannabis use was linked with cardiovascular disease in a survey of nearly half a million US adults, with higher risk of stroke a particular concern in the observational study.
Participants were interviewed by phone as part of the Behavioral Risk Factor Surveillance System. Those who reported cannabis use also reported higher rates of cardiovascular disease compared to nonusers, researchers will report at the AHA meeting.
This was true even in adults ages 18 to 44, in never-smokers, and in people without diabetes, hypertension, or obesity, they also found.
Compared with non-users, those who used cannabis up to five days per month had 23% higher odds of also reporting a history of cardiovascular disease. Participants who reported using it for 16 to 30 days per month had 21% higher odds of reporting cardiovascular disease.
The strongest link between cannabis use and cardiovascular disease was with stroke, although the findings were somewhat confounding. Low-frequency cannabis use was associated with 40% higher odds of stroke, and heavy use with 25% higher odds of stroke.
“We expected that the chances of heart disease would gradually rise as people used cannabis more often, but that wasn’t the case,” study leader Dr. Aabha Divya of Tulane University School of Medicine said in a statement.
While the study wasn’t designed to prove cannabis use caused heart disease, this is the second observational study to suggest that cannabis exposure in nonsmokers may be a risk factor for developing heart disease, Robert Page of the University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, who wasn’t involved in the study, said in a statement.
“Clinicians should be addressing cannabis use with their patients as they would tobacco use when considering the risk of cardiovascular disease,” said Page, who chaired the writing group for the American Heart Association’s 2020 cannabis scientific statement.
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(Reporting by Nancy Lapid; Editing by Bill Berkrot)
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