Metformin Blunts Diabetics’ Cardiovascular Disease

Metformin was introduced to the United Kingdom in 1958, Canada in 1972, and the United States in 1995.  The delay in the USA was due to a mistaken belief that the drug carried serious side effects.  Now metformin is the most widely prescribed anti-diabetic drug in the world.  And a new study has shown that it can reduce mortality from cardiovascular diseases associated with atherosclerosis in diabetic patients.  This international study is published in the Archives of Internal Medicine.

Metformin has already been shown to reduce overall mortality in overweight diabetics.  The present study was designed to determine if the drug was linked to a difference in mortality in patients with a history of coronary artery disease, cerebrovascular disease, or peripheral arterial disease.  Almost 20,000 subjects were registered, of whom just over a third were taking metformin as part of their treatment.  Mortality over the next 2 years was determined.

The 2-year mortality was 6.3% in those using metformin, compared with 9.8% in those not using the drug.  Lower mortality with metformin was found in the various subgroups analyzed – those over 65, those with a history of heart failure, and those with chronic kidney disease.

The use of metformin is contraindicated if there’s a possibility of the occurrence of lactic acidosis, which has led to its being avoided in patients with heart failure or kidney disease.  The present study, however, shows a possible benefit of metformin on mortality in these conditions, if the findings can be confirmed in prospective studies.               

It’s appropriate here to mention another new study that shows that erectile dysfunction (ED) in men is associated with a 19% increased risk of cardiovascular disease events (heart attack, stroke, angina, etc).  Therefore, diabetic men who develop ED should undergo assessment for cardiovascular disease risk factors (and appropriate management) rather than just obtaining a quick prescription for Viagra.