Sullivan D et al. – Apparent differences in the risk of cardiovascular (CVD) outcomes associated with oral hypoglycemics therapy were largely abolished by adjustment for diabetes and CVD risk factors.

• Patients receiving metformin or sulphonylureas without insulin therapy were compared for the relative risk of CVD outcomes, adjusted for differences in baseline characteristics likely to affect risk.

• Metformin–treated patients were likely to be younger, female, or obese.
• Metformin was associated with higher levels of lipids (other than LDL–C) and homocysteine (P<0.001).
• Sulphonylurea–treated patients had a longer history of diabetes and more CVD and microvascular disease.
• Sulphonylurea treatment was associated with higher plasma creatinine and lower plasma HDL–C (P<0.001).
• The risks of all CVD outcomes were higher for those on sulphonylureas than diet alone, but were nonsignificant after adjustment for the duration and intensity of diabetes and severity of risk factors.
• Metformin and sulphonylureas did not significantly influence the benefits of fenofibrate on CVD outcomes.