Type 2 diabetes treatment could reduce risk of heart disease

Study reports that heart failure could be prevented by taking metformin.

A treatment often prescribed to people with type 2 diabetes could have additional benefits for people at risk of developing heart disease.

The findings of a recently published study by researchers at the University of Dundee found that metformin – a treatment for type 2 diabetes, could also help millions of people living with heart and circulatory disease in the UK.

The findings of two studies involving the drug, presented at the recent British Cardiovascular Society Conference in Manchester, provided promising results for patients with heart damage caused by high blood pressure and a condition called aortic stenosis, which causes heart failure.

The MET-REMODEL trial, funded by the British Heart Foundation, found that metformin could reverse harmful thickening of the left ventricle - the heart's main pumping chamber. It also helped to bring down high blood pressure and reduce bodyweight in patients who had a heart attack.

The study involved treating people with coronary heart disease with metformin or placebo over a period of 12 months to see how the drug affected the heart and circulatory system. The dangerous thickening of the left ventricle was reduced by twice as much in those taking metformin compared to the placebo. Patients who took metformin also had reduced blood pressure and lost an average of 3kg, compared to no weight loss in the placebo group.

Thickening of the heart’s main pumping chamber, or left ventricular hypertrophy, is a serious risk factor for heart attack and heart failure. The symptoms are hard to detect and many people do not know they have it until they have a heart attack or stroke. Major causes of left ventricular hypertrophy include high blood pressure, inflammation and insulin resistance, which are also believed to be the main causes of coronary heart disease.

A second study, funded by Scotland’s Chief Scientist Office (CSO), researchers looked at medical records of people with diabetes with a condition called aortic stenosis (AS) - where the main artery which supplies blood to the body is narrowed. The condition affects around 40% people over the age of 60 in the UK and can lead to heart failure.

Researchers concluded that people with diabetes with AS who were treated with metformin were less likely to die from heart attack, stroke or heart failure than those on other diabetes medication.

In addition to working on type 2 diabetes complications including insulin resistance and inflammation, researchers believe that metformin can provide additional health benefits by reducing the size of the left ventricle.

Dr Ify Mordi, a Clinical Lecturer in Cardiology at the University of Dundee, who co-led the research, said: “Metformin is emerging as a serious prospect for the treatment of some forms of heart and circulatory disease. We know from our previous research that it can reduce inflammation, which is understood to be a major player in the development of heart disease. This new research shows that metformin could potentially become a new treatment option for patients with aortic stenosis and thickening of the left ventricle. We need to undertake bigger studies to confirm our findings, but if successful this could offer hope for thousands, if not millions of patients across the UK.”

Researchers believed that repurposing cheap and readily available drugs, such as type 2 diabetes treatment metformin, to treat other health conditions could potentially save the NHS billions of pounds every year.

The development of a new drug from discovery to approval for use in people costs on average £2 billion and can take up to 12 years.

Professor Jeremy Pearson, Associate Medical Director at the British Heart Foundation, said: “These studies provide real hope that metformin might help to reduce deaths from heart and circulatory diseases, which currently claim thousands of lives every year. Repurposing of drugs like metformin is a great example of how scientists can harness the power of medications which have more than one target in the body.”

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