title: Sulfonylurea and the Heart: Theoretically a Compounded Question from a Pathophysiological Perspective.
abstract: Evidence from literature illustrates that from a pathophysiological perspective, sulfonylureas (SU) may impact the heart three ways: directly by intrinsic properties from a pharmacological receptor perspective, indirectly by adverse effects related to hypoglycemia, and obesity. From a pharmacologlogical receptor perspective, SU can bind to ATP-sensitive potassium channels in cardiomyocytes. Channel binding by SU in cardiac tissue may prevent ischemia myocardial protective mechanisms. From a pathophysiological perspective, obesity is associated with cardiac issues such as pulmonary hypertension, left ventricular hypertrophy, arrhythmia, and atrial fibrillation. From a pathophysiological perspective, hypoglycemia is associated with cardiac sympathetic activation and QT prolongation. With the high prevalence and incidence of diabetes, obesity and aging, future basic and clinical studies should further explore the questions related to the pathophysiology of SU utilization and potential cardiac impact in randomized clinical trials and real-world outcome research settings.
authors: Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario.
authors: Pendar
authors: P
authors: Farahani
mesh_terms: D000375:Aging / Q000502:physiology; D002170:Canada / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects* / Q000494:pharmacology*; D032383:Myocytes, Cardiac / Q000187:drug effects; D015221:Potassium Channels / Q000187:drug effects; D013453:Sulfonylurea Compounds / Q000009:adverse effects* / Q000494:pharmacology*
chemical_list: D007004:Hypoglycemic Agents; D015221:Potassium Channels; D013453:Sulfonylurea Compounds
keywords: cardiovascular risks; diabetes; elderly; hypoglycemia; obesity; sulfonylurea