This review paper discusses the benefit-risk profile of thiazolidinediones (TZDs), which are pharmacological agents for the treatment of type 2 diabetes, and pays particular attention to the heart. As the use of TZDs sometimes leads to common side effects such as weight gain, edema, and, in some cases, congestive heart failure, the mechanisms leading to these side effects are reviewed. Buckingham and Hanna extensively describe the mechanisms by which TZDs induce fluid retention and edema and suggest that some diuretics could be used together with TZDs in order to address fluid retention and TZD-induced (or exacerbated) edema. Effects of older antihyperglycemic drugs on the heart, cardiovascular events, and mortality are also discussed. The authors conclude that although questions still exist regarding the cardiac safety of TZDs, congestive heart failure associated with TZDs rarely occurs in patients without underlying risk factors for this disease.
Documentation centre