The popular diabetes medication Avandia increases the risk of heart failure, heart attacks and death in older adults, according to a Canadian study.

The study looked at the glitazone class of drugs, which include rosiglitazone, the pharmaceutical name for Avandia and pioglitazone (sold under the name Actos).

Researchers looked at patients aged 65 years or older who were treated with diabetes medications and then followed them for almost four years, until March 2006.

During this period of time, 7.9 percent of patients made a visit to the hospital for congestive heart failure, 7.9 percent went to the hospital for a heart attack, and 19 percent died.

The researchers found that, compared to patients taking other diabetes medications, patients taking glitazones (Avandia & Actos)had a 60 percent relative increase in heart failure, a 40 percent relative increase in heart attacks, and a 30 percent relative increase in death.

This translates into an estimated three additional episodes of heart failure, four additional heart attacks and five additional deaths for every 100 individuals taking these drugs, over a four-year period in the older population.

The study comes on the heels of the Food and Drug Administration in the United States deciding to slap a black box label warning on Avandia, telling patients that it may increase the risk of heart attacks.

Co-author of the study Dr. David Alter says patients taking Avandia should not panic. "Treatment decisions must remain individualized with doctors and patients weighing the potential harms and benefits of these drugs, especially when used among the elderly who are at higher-risk of cardiac complications," he told reporters.

Dr. Amir Hanna, deputy division head of endocrinology and metabolism at St. Michael's Hospital in Toronto and a member of the national board of the Canadian Diabetes Association, says he still believes that Avandia and other glitazones have a role to play in treating diabetes.

"We have to choose our patients well. We have to balance the pros and cons of each drug," he said.

The study has been published in the "Journal of the American Medical Association."

(Xinhua News Agency December 12, 2007)