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An overview of the beneficial cardiovascular effects of thiazolidinediones

Fadi A El-Atat, John Nicasio, Luther T Clark and Samy I McFarlane

Cardiovascular disease is a major cause of morbidity and mortality in people with diabetes and those with the metabolic syndrome. With the rising prevalence of these disorders that is now reaching epidemic proportions around the globe, cardiovascular disease is also expected to rise substantially. Although lifestyle and dietary interventions are the first-line approaches in the management of diabetes and the metabolic syndrome, pharmacotherapy is almost always necessary to achieve optimal control of glycemia, elevated blood pressure, microalbuminuria, dyslipidemia and other associated cardiovascular disease risk factors. Therapeutic agents that have beneficial cardiovascular effects are attractive choices in treating these high-risk patients. Thiazolidinediones have recently gained momentum due to an increase in interest in their insulin-sensitizing, pleiotrophic effects and their potential to reduce the risk of cardiovascular disease in people with diabetes and reduce diabetes itself. In this article, the beneficial cardiovascular effects of thiazolidinediones in people with insulin resistance and diabetes shall be reviewed, highlighting their antiatherosclerotic and anti-inflammatory role together with their potential effects on dyslipidemia, visceral obesity, hypertension and microalbuminuria.