Research

Hormonal

Thiazolidinediones (TZDs) increase the risk of hospitalization for heart failure through fluid retention mediated by sodium reabsorption.

If you have Type 2 Diabetes and Heart Failure, especially if it is moderate to severe (NYHA class III or IV), you should likely avoid Thiazolidinediones (like Actos or Avandia). These drugs cause fluid retention and significantly increase the risk of being hospitalized for heart failure. Your doctor will likely choose a different medication.

StrongRefutesHIGH confidence
Thiazolidinediones increase the risk of hospitalized HF through increasing renal tubular sodium reabsorption mediated via both the genomic and non-genomic action of PPARγ... Rosiglitazone markedly increased the risk of HHF (HR, 7.04 (95% CI, 1.60–31.0))
Chih‐Neng Hsu et al. · Life · 2023

Why this rating

Supported by multiple RCTs (DREAM, PROactive) and meta-analyses showing increased HF risk.

Source

Anti-Diabetic Therapy and Heart Failure: Recent Advances in Clinical Evidence and Molecular Mechanism

Chih‐Neng Hsu et al. · Life · 2023

DOI 10.3390/life13041024

narrative_reviewCited 8×
Read the paper
DOI resolved against Crossref · corpus check 2026-06-10

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