Thiazide Exposure and Cardiovascular Risk in Type 2 Diabetes Mellitus: A Point of Clarification.
Pubmed ID: 32008437
Pubmed Central ID: PMC7035168
Journal: Hypertension (Dallas, Tex. : 1979)
Publication Date: 03/01/2020
Affiliation: College of Pharmacy, and Division of Cardiovascular Medicine, Department of Medicine, College of Medicine (C.J.P., R.M.C.-D.), University of Florida, Gainesville.
MeSH Terms: Humans, Cardiovascular Diseases, Risk Factors, Hypertension, Blood Pressure, Diabetes Mellitus, Type 2, Sodium Chloride Symporter Inhibitors, Heart Disease Risk Factors, Thiazides
Grants: K01 HL138172
Authors: Smith SM, Pepine CJ, Cooper-DeHoff RM, Winterstein AG
Cite As: Smith SM, Winterstein AG, Pepine CJ, Cooper-DeHoff RM. Thiazide Exposure and Cardiovascular Risk in Type 2 Diabetes Mellitus: A Point of Clarification. Hypertension 2020 Mar;75(3):e2-e5. Epub 2020 Feb 3.
A recently published analysis in <i>Hypertension</i> suggests that thiazide use, versus nonuse, is associated with excess risk of adverse cardiovascular outcomes in patients with diabetes mellitus enrolled in the ACCORD trial (Action to Control Cardiovascular Risk in Diabetes). Here, we replicate these findings using the same publicly available datasets and following their reported methods. We further show that possible misclassification of thiazide exposure exists in the original analysis. We perform alternative analyses that correct for this misclassification to highlight the impact that misclassification can have on observed associations between an exposure (eg, thiazides) and outcomes (eg, stroke and major adverse cardiovascular events).