Effects of Exenatide on Systolic Blood Pressure in Subjects With Type 2 Diabetes

Okerson, Ted; Yan, Ping; Stonehouse, Anthony H.; Brodows, Robert G.

doi:10.1038/ajh.2009.245

Cited by 173 publications

(138 citation statements)

References 34 publications

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“…Animal studies showed their antihypertensive and natriuretic effects. [48][49][50] In humans, treatment of type 2 diabetic patients with these drugs was associated with improvement of systolic blood pressure, 51 and improvement of endothelial function, independent of the improvement of insulin sensitivity. 52 The precise mechanisms underlying the reported effects of incretin mimetics on cardiovascular system are not fully clear as yet.…”

mentioning

confidence: 99%

Insulin resistance in young, lean male subjects with essential hypertension

Penesová

Cizmárová²,

Белан

et al. 2010

J Hum Hypertens

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Impaired insulin action, frequently found in essential hypertension (HT), is modified by other factors, such as higher age, accumulation of body fat, dyslipidaemia, impaired glucose metabolism and endothelial dysfunction. In addition, antihypertensive and insulin-sensitizing medication itself may significantly affect cardiovascular and metabolic milieu. The aim of this study was to assess insulin sensitivity, acute insulin response, lipidaemic status and the adipokines' concentrations with regard to abdominal fat distribution in young, lean male subjects with treatment-naïve essential HT and in matched healthy normotensive (NT) subjects. We studied 27 HT patients (age: 19.9 ± 0.6 years; body mass index (BMI): 22.9±0.5 kg m À2) and 15 NT controls (age: 22.3±1.0 years; BMI: 23.7 ± 0.6 kg m À2). The subjects underwent an oral and an intravenous glucose tolerance test (OGTT, IVGTT) on separate days in random order. Higher fasting insulin (Po0.001), non-esterified fatty acids (Po0.05) and plasminogen activator inhibitor factor 1 concentrations (Po0.05) were found in HT patients when compared with NT patients. Despite comparable anthropometric parameters and body fat distribution assessed by magnetic resonance imaging in both groups, newly diagnosed untreated young hypertensive male subjects showed decreased insulin sensitivity, augmented insulin response to both oral and intravenous glucose load (Po0.01; Po0.05 respectively) and 'higher still normal' 2-h plasma glucose levels during OGTT. Untreated, young, lean hypertensive male subjects, with distribution of abdominal adipose tissue and lipid profile comparable with their healthy NT matched counterparts, showed considerable signs of insulin resistance and hyperinsulinaemia. We hypothesize that insulin resistance is the initial feature, which is influenced by several environmental factors, and HT is one of their common consequences.

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mentioning

confidence: 99%

Insulin resistance in young, lean male subjects with essential hypertension

Penesová

Cizmárová²,

Белан

et al. 2010

J Hum Hypertens

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“…In a small double blind placebo controlled pilot study of normotensive type two diabetic individuals, exenatide lowered the systolic blood pressure with no effect on both the diastolic blood pressure and the heart rate [31]. Okerson et al conducted a larger study with longer duration that also showed the ability of exenatide to reduce the systolic blood pressure as compared to placebo and insulin.…”

Section: Glp1 and Cardiovascular Risk Factorsmentioning

confidence: 99%

GLP 1 and Macrovascular Complications

Sleiman¹,

Azar²

2011

J Diabetes Metab

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Type two diabetes remains to be one of the most challenging chronic diseases affecting 26 million people in the United States. Despite advances in the management of this illness, a large number of diabetics suffer from disease related complications. Heart disease and stroke account for a significant percentage of death in diabetics. Advancing treatment options for diabetics beyond glycemic control and Hba1c levels to prevent macrovascular complications should be the target of our management. GLP1, a member of the pro-glucagon incretin family, and GLP1 analogues seems to have beneficial effects on the macrovascular levels, in addition to their established effect on the glycemic control. This article reviews the potential effect of GLP1 family on the macrovascular complications including cardiovascular, cerebrovascular, and peripheral vascular diseases.

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“…Exenatide elicits a significant improvement in glycemic control, including postprandial glucose concentration, 35,36 and many patients treated with exenatide experience significant weight loss. [37][38][39][40][41][42] Furthermore, exenatide has also shown to have a positive effect on blood pressure in hypertensive patients, 37,38,43 but there are no consistent trends in regards to exenatide's effect on lipids. [44][45][46][47][48] Numerous studies have compared exenatide to placebo [49][50][51][52] or insulin 47,[53][54][55] in patients receiving metformin and/or sulfonylureas.…”

Section: Clinical Studiesmentioning

confidence: 99%

“…However, mean systolic blood pressures were near target level 71 of ,130 mmHg (mean of 130 mmHg and 133 mmHg) and mean diastolic levels were below the 80 mmHg target (mean 75 mmHg and 76 mmHg); blood pressure outcomes were not reported by baseline blood pressure. A recent meta-analysis of clinical trial data, as discussed above, found that blood pressure reduction appears to occur in patients with elevated blood pressure but not necessarily in normotensive patients, 43 which may help explain why an effect on blood pressure was generally not observed in exenatide retrospective analyses.…”

Section: Retrospective Outcomes Analysesmentioning

confidence: 99%

Exenatide: Review of its Role as Adjunctive Therapy in Patients with Type 2 Diabetes

Bellows

Hunter²,

McAdam‐Marx³

2011

Clinical Medicine Reviews in Vascular Health

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Abstract:Exenatide was the first glucagon like peptide-1 (GLP-1) agonist approved for treatment in patients with type 2 diabetes. Clinical trials and real-world studies of exenatide, a subcutaneous injection given twice per day, indicate that it significantly reduces hemoglobin A1c values and weight with a low risk of hypoglycemia. Exenatide is generally well tolerated, but transient nausea and vomiting are commonly occurring side effects. Given this profile, exenatide has been shown to be cost effective relative to insulin glargine. Thus, exenatide is a treatment option that should be considered for patients with type 2 diabetes that is uncontrolled on one or more oral agents and for which additional weight gain and hypoglycemia are undesirable.

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Effects of Exenatide on Systolic Blood Pressure in Subjects With Type 2 Diabetes

Abstract: These results support the need for a prospective, randomized, controlled study of BP changes during exenatide treatment in patients with hypertension and type 2 diabetes.

Cited by 173 publications

References 34 publications

Insulin resistance in young, lean male subjects with essential hypertension

Insulin resistance in young, lean male subjects with essential hypertension

GLP 1 and Macrovascular Complications

Exenatide: Review of its Role as Adjunctive Therapy in Patients with Type 2 Diabetes

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