WASHINGTON — The widely used diabetes drug Avandia should be pulled off the market, federal health officials said Monday, urging action in response to studies linking the drug to an increased risk of heart attacks.

BILLERICA, Mass. — Patricia Ortiz and her husband Sebastian cut back on dining out, nights at the movies, and even opted for a civil wedding ceremony instead of a big church affair so they could afford to buy their $389,000 three-bedroom colonial.