The effect of glucagon-like peptide-1 receptor agonists on 24-hour ambulatory blood pressure: a confirmatory meta-analysis

Abstract

Objective Hypertension augments overall cardiovascular risk in patients with type 2 diabetes mellitus (T2DM); however, control rates remain suboptimal. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have revolutionized the field of T2DM therapeutic management due to their multiple pleiotropic effects. Therefore, we sought to determine the effect of this class on ambulatory blood pressure monitoring (ABPM), pooling data from relevant randomized controlled trials (RCTs). Methods We searched major electronic databases, namely PubMed and Cochrane Library, along with gray literature sources, for RCTs assessing the effect of various GLP-1RAs on ambulatory BP in patients with T2DM. Results We pooled data from seven RCTs in total. GLP-1RA treatment compared to placebo or active control resulted in a nonsignificant decrease in 24-h SBP (mean difference = −1.57 mm Hg; 95% CI,−4.12 to 0.98; I 2 = 63%) and in 24-h DBP (mean difference = 1.28 mmHg; 95% CI,−0.31 to 2.87; I 2 = 49%). No subgroup differences between the various GLP-1RAs were detected. Conclusion GLP-1RAs treatment does not influence either systolic or diastolic ambulatory BP in patients with T2DM.

Effect of Glucagon-like Peptide-1 Receptor Agonists on Cardio-Metabolic Risk Factors among Obese/Overweight Individuals Treated with Antipsychotic Drug Classes: An Updated Systematic Review and Meta-Analysis of Randomized Controlled Trials

“…Furthermore, our findings on lipid profile parameters are consistent with previous meta-analyses examining the impact of GLP-1RAs on lipid profiles in T2DM and non-alcoholic fatty liver disease [ 40 , 41 ]. Finally, we failed to document a significant effect of GLP-1RAs on office SBP and DBP among obese subjects with psychotic disorders, a finding similar to a previous meta-analysis performed by some of us in the T2DM population [ 42 ]. As a result, regardless of T2DM status at baseline, the effect of GLP-1RAs on cardio-metabolic risk factors appears to be similar in subjects with and without concomitant psychotic disorder.…”

Diabetes mellitus y su manejo en escenarios difíciles

“…Por otro lado, los análogos de GLP-1 han demostrado disminuir el peso, los niveles de presión arterial (PA), tanto sistólica como diastólica; también, la disminución de ECV24 . En el estudio LEADER, en donde se evaluó el Liraglutide, se demostró la reducción del 13 % en los eventos cardiovasculares en el grupo de la intervención, en comparación con el grupo control25 .…”