Glucagon-like peptide-1 receptor agonists modestly reduced blood pressure among patients with and without diabetes mellitus: A meta-analysis and meta-regression.
Diabetes Obes Metab
; 26(6): 2209-2228, 2024 Jun.
Article
em En
| MEDLINE
| ID: mdl-38505997
ABSTRACT
AIM:
The cardiovascular benefits provided by glucagon-like peptide-1 receptor agonists (GLP-1RAs) extend beyond weight reduction and glycaemic control. One possible mechanism may relate to blood pressure (BP) reduction. We aim to quantify the BP-lowering effects of GLP1-RAs.METHODS:
A comprehensive database search for placebo-controlled randomized controlled trials on GLP-1RA treatment was conducted until December 2023. Data extraction and quality assessment were carried out, employing a robust statistical analysis using a random effects model to determine outcomes with a mean difference (MD) in mmHg and 95% confidence intervals (CIs). The primary endpoint was the mean difference in systolic BP (SBP) and diastolic BP. Subgroup analyses and meta-regressions were done to account for covariates.RESULTS:
Compared with placebo, GLP-1RAs modestly reduced SBP [semaglutide MD -3.40 (95% CI -4.22 to -2.59, p < .001); liraglutide MD -2.61 (95% CI -3.48 to -1.74, p < .001); dulaglutide MD -1.46 (95% CI -2.20 to -0.72, p < .001); and exenatide MD -3.36 (95% CI -3.63 to -3.10, p < .001)]. This benefit consistently increased with longer treatment durations. Diastolic BP reduction was only significant in the exenatide group [MD -0.94 (95% CI -1.78 to -0.1), p = .03]. Among semaglutide cohorts, mean changes in glycated haemoglobin and mean changes in body mass index were directly associated with SBP reduction.CONCLUSION:
Patients on GLP-1RA experienced modest SBP lowering compared with placebo. This observed effect was associated with weight/body mass index reduction and better glycaemic control, which suggests that BP-lowering is an indirect effect of GLP-1RA and unlikely to be responsible for the benefits.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Pressão Sanguínea
/
Diabetes Mellitus Tipo 2
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Receptor do Peptídeo Semelhante ao Glucagon 1
/
Hipoglicemiantes
Limite:
Humans
Idioma:
En
Ano de publicação:
2024
Tipo de documento:
Article