Effect of GLP-1 Mimetics on Blood Pressure and Relationship to Weight Loss and Glycemia Lowering: Results of a Systematic Meta-Analysis and Meta-Regression

Katout, Mohammad; Zhu, Hong; Rutsky, Jessica; Shah, Parthy; Brook, Robert D.; Zhong, Jixin; Rajagopalan, Sanjay

doi:10.1093/ajh/hpt196

Cited by 120 publications

(85 citation statements)

References 40 publications

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“…This may be due to the small sample size of patients receiving these medications or the presence of confounding variables that distorted the association between the use of these drugs and BP control. The positive effects of these drugs on lowering BP is reported in the literature [43,44]. Therefore, this result should be investigated by r further studies.…”

Section: Discussionmentioning

confidence: 79%

Factors Associated With Hypertension Prevalence and Control Among Lebanese Type 2 Diabetic Patients

Soubra

Nureddin

Omar

et al. 2016

Int J Pharm Pharm Sci

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Objective: The objectives of this study were to assess the prevalence of hypertension and the level of blood pressure (BP) control among a cohort of diabetic Lebanese patients on antihypertensive medications, as well as to identify factors associated with hypertension prevalence and uncontrolled BP. Methods:This cross-sectional retrospective study was conducted in a tertiary health care clinic that is specialized in the management and follow-up of diabetic outpatients.Results: Among the 700 type 2 diabetes mellitus patient files that were screened529 (75%) were found to have hypertension. Hypertension was more prevalent in women, patients aged ≥65-year-old, and those having a body mass index (BMI) of ≥30 (kg/m 2 Conclusion:Hypertension is prevalent among the study patients. However, attainment of BP control was poor among these patients. Therefore, there is a need for studies that determine reasons behind this low BP control rate in order to design interventions aiming at improving the standard of care for these patients.) (p-value<0.05). Among the hypertensive cohort, 465 T2DM were on antihypertensive medications and were included in the hypertension control analysis. Ninety-three patients (20%) attained BP control (SBP<140 and DBP<90 mmHg). Multivariate analyses revealed three factors that were significantly associated with uncontrolled BP control: Age being ≥65 y (adjusted OR = 1.96 (95% CI: 1.07-3.61, p-value<0.05), male gender (adjusted OR = 2.57, 95% CI: 1.41-4.66, p-value<0.05) and uncontrolled HDL (adjusted OR = 1.58, 95% CI: 1.33-2.01, p-value = 0.05).

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Section: Discussionmentioning

confidence: 79%

Factors Associated With Hypertension Prevalence and Control Among Lebanese Type 2 Diabetic Patients

Soubra

Nureddin

Omar

et al. 2016

Int J Pharm Pharm Sci

View full text Add to dashboard Cite

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“…GLP-1 receptor agonist treatment has however been associated with a small increase in heart rate [93] (Table 3, in the Appendix). A meta-analysis of 22 trials showed that GLP-1 agonists overall resulted in a significant increase in heart rate with a weighted mean difference of 1.86 beats per minute (bpm, 95% CI: 0.85-2.87) compared with placebo and 1.90 bpm (95% CI: 1.30-2.50) compared with active control (all p < 0.05) [94].…”

Section: Cardiovascular Systemmentioning

confidence: 99%

Adverse Effects of GLP-1 Receptor Agonists

2014

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■ AbstractGlucagon-like peptide-1 (GLP-1) receptor agonists are a class of injective anti-diabetic drugs that improve glycemic control and many other atherosclerosis-related parameters in patients with type 2 diabetes (T2D). However, the use of this relatively new class of drugs may be associated with certain adverse effects. Concerns have been expressed regarding the effects of these drugs on pancreatic and thyroid tissue, since animal studies and analyses of drug databases indicate an association of GLP-1 receptor agonists with pancreatitis, pancreatic cancer, and thyroid cancer. However, several meta-analyses failed to confirm a cause-effect relation between GLP-1 receptor agonists and the development of these adverse effects. One benefit of GLP-1 receptor agonists is that they do not cause hypoglycemia when combined with metformin or thiazolidinediones, but the dose of concomitant sulphonylurea or insulin may have to be decreased to reduce the risk of hypoglycemic episodes. On the other hand, several case reports have linked the use of these drugs, mainly exenatide, with the occurrence of acute kidney injury, primarily through hemodynamic derangement due to nausea, vomiting, and diarrhea. The most common symptoms associated with the use of GLP-1 receptor agonists are gastrointestinal symptoms, mainly nausea. Other common adverse effects include injection site reactions, headache, and nasopharyngitis, but these effects do not usually result in discontinuation of the drug. Current evidence shows that GLP-1 receptor agonists have no negative effects on the cardiovascular risk of patients with T2D. Thus, GLP-1 receptor agonists appear to have a favorable safety profile, but ongoing trials will further assess their cardiovascular effects. The aim of this review is to analyze critically the available data regarding adverse events of GLP-1 receptor agonists in different anatomic systems published in Pubmed and Scopus. Whenever possible, certain differences between GLP-1 receptor agonists are described. The review also provides the reader with structured data that compare the rates of the most common adverse effects for each of the various GLP-1 receptor agonists.

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“…The cardioprotective effects of GLP-1 agonists have been well documented in pre-clinical studies. In the clinical setting, similar positive effects have been observed to various degrees in pilot studies, and the mechanism was thought to be related to reduced apoptosis and nuclear oxidative stress and improvement in myocardial glucose metabolism [46].…”

Section: Glucagon-like Peptide-1 Agonistsmentioning

confidence: 61%

Lower Cardiovascular Risk with Diabetic Drugs: A Paradigm Shift from Glucocentricity to Cardio Protectiveness

Mohanty¹

2017

Diabetes Case Rep

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Cardiovascular disease is the leading cause of mortality and morbidity among diabetic patients. There by reducing cardiovascular risk is a major focus of diabetic management. International Diabetes Federation (IDF) in 2014 has projected that 592 million population will be affected by diabetes by the year 2035 from the present status of 387 million out of which 90% will have type 2 diabetes. The prevalence of diabetes and cardiovascular disease is growing exponentially. This rising tide of diabetes around the globe, the double jeopardy of diabetes and cardiovascular disease is infact a time bomb which may result in an explosion of these cardiovascular complications unless aggressive management of diabetes is done. While tight glycaemic control decrease the onset of microvascular complications evidence that it decreases macrovascular complications is limited. Lowering blood glucose levels in patients with diabetes mellitus is a too simplistic goal. The key component being how to lower blood sugar and how much. Diabetes drugs, even within the same "class" yield dramatically different cardiovascular outcomes. Infact a number of diabetic drugs may actually increase the risk of major cardiovascular events posing a challenge for the clinicians to select drugs for patients with type 2 diabetes mellitus. Thus, the treatment of type 2 diabetes needs to be invidualized and complex in which targeting cardiovascular risk factor is an important component. After the updated publication by Nissen and Wolski about the cardiovascular adverse outcomes of rosiglitazone both FDA (Food and Drug Administration) and European medicine agency (EMA) made it mandatory to have CVOT (Cardiovascular outcome trial) as an integral part of drug approval process. Therefore, the need of the hour is to evaluate anti diabetic drugs in relation to cardiovascular risk.This review discusses the available evidence regarding cardiovascular safety of commonly used oral anti-diabetic medications.

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Effect of GLP-1 Mimetics on Blood Pressure and Relationship to Weight Loss and Glycemia Lowering: Results of a Systematic Meta-Analysis and Meta-Regression

Abstract: This meta-analysis provides evidence that GLP-1 analogs reduce sitting SBP. These findings may support potentially favorable long-term cardiovascular outcomes.

Cited by 120 publications

References 40 publications

Factors Associated With Hypertension Prevalence and Control Among Lebanese Type 2 Diabetic Patients

Factors Associated With Hypertension Prevalence and Control Among Lebanese Type 2 Diabetic Patients

Adverse Effects of GLP-1 Receptor Agonists

Lower Cardiovascular Risk with Diabetic Drugs: A Paradigm Shift from Glucocentricity to Cardio Protectiveness

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