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

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

Research output: Contribution to journalArticle

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Abstract

background Incretin therapies such as glucagon-like peptide 1 (GLP-1) agonists are commonly used for the treatment of type 2 diabetes mellitus. GLP-1 mimetics, besides improving glycemic control, have been shown to influence multiple pathways regulating blood pressure (BP). We investigated the GLP-1 analogs effects on BP from published randomized studies using a meta-analytic approach. methods Thirty-three trials (12,469 patients) that assessed the efficacy of GLP-1 analogs on glycemic control (HbA1C) over 12-56 weeks that met additional criteria, including the availability of standardized sitting BP assessment and weight parameters, were identified. Comparator therapy included oral antiglycemic drugs or placebo. The weighted mean difference (WMD) in systolic BP (SBP) change was calculated using a random-effects model after performing a test for heterogeneity. results Forty-one percent of patients were treated with liraglutide (0.3-3 mg once daily), whereas 59% were treated with exenatide (5-10 μg twice daily or 2 mg weekly). GLP-1 treatment achieved a greater SBP reduction than comparator therapy (WMD = 2.22 mm Hg; 95% confidence interval (CI) = -2.97 to -1.47). In the pooled analysis, GLP-1 had beneficial effects on weight loss (WMD = -2.56 kg; 95% CI = -3.12 to -2.00), HbA1c reduction (WMD = -0.41%; 95% CI = -0.78 to -0.04) but was associated with a heart rate increase (WMD = 1.30 bpm; 95% CI = 0.26-2.33). In a separate meta-regression analysis, the degree of SBP change was not related to baseline BP, weight loss, or improvement in HbA1C. conclusions This meta-analysis provides evidence that GLP-1 analogs reduce sitting SBP. These findings may support potentially favorable long-term cardiovascular outcomes.

Original languageEnglish (US)
Pages (from-to)130-139
Number of pages10
JournalAmerican Journal of Hypertension
Volume27
Issue number1
DOIs
StatePublished - Jan 2014

Fingerprint

Glucagon-Like Peptide 1
Meta-Analysis
Weight Loss
Blood Pressure
Confidence Intervals
Incretins
Therapeutics
Type 2 Diabetes Mellitus
Heart Rate
Placebos
Regression Analysis
Weights and Measures
Pharmaceutical Preparations

Keywords

  • Blood pressure
  • Exenatide
  • GLP-1
  • Hypertension
  • Liraglutide
  • Meta-analysis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

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.

In: American Journal of Hypertension, Vol. 27, No. 1, 01.2014, p. 130-139.

Research output: Contribution to journalArticle

Katout, Mohammad ; Zhu, Hong ; Rutsky, Jessica ; Shah, Parthy ; Brook, Robert D. ; Zhong, Jixin ; Rajagopalan, Sanjay. / 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. In: American Journal of Hypertension. 2014 ; Vol. 27, No. 1. pp. 130-139.
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abstract = "background Incretin therapies such as glucagon-like peptide 1 (GLP-1) agonists are commonly used for the treatment of type 2 diabetes mellitus. GLP-1 mimetics, besides improving glycemic control, have been shown to influence multiple pathways regulating blood pressure (BP). We investigated the GLP-1 analogs effects on BP from published randomized studies using a meta-analytic approach. methods Thirty-three trials (12,469 patients) that assessed the efficacy of GLP-1 analogs on glycemic control (HbA1C) over 12-56 weeks that met additional criteria, including the availability of standardized sitting BP assessment and weight parameters, were identified. Comparator therapy included oral antiglycemic drugs or placebo. The weighted mean difference (WMD) in systolic BP (SBP) change was calculated using a random-effects model after performing a test for heterogeneity. results Forty-one percent of patients were treated with liraglutide (0.3-3 mg once daily), whereas 59{\%} were treated with exenatide (5-10 μg twice daily or 2 mg weekly). GLP-1 treatment achieved a greater SBP reduction than comparator therapy (WMD = 2.22 mm Hg; 95{\%} confidence interval (CI) = -2.97 to -1.47). In the pooled analysis, GLP-1 had beneficial effects on weight loss (WMD = -2.56 kg; 95{\%} CI = -3.12 to -2.00), HbA1c reduction (WMD = -0.41{\%}; 95{\%} CI = -0.78 to -0.04) but was associated with a heart rate increase (WMD = 1.30 bpm; 95{\%} CI = 0.26-2.33). In a separate meta-regression analysis, the degree of SBP change was not related to baseline BP, weight loss, or improvement in HbA1C. conclusions This meta-analysis provides evidence that GLP-1 analogs reduce sitting SBP. These findings may support potentially favorable long-term cardiovascular outcomes.",
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N2 - background Incretin therapies such as glucagon-like peptide 1 (GLP-1) agonists are commonly used for the treatment of type 2 diabetes mellitus. GLP-1 mimetics, besides improving glycemic control, have been shown to influence multiple pathways regulating blood pressure (BP). We investigated the GLP-1 analogs effects on BP from published randomized studies using a meta-analytic approach. methods Thirty-three trials (12,469 patients) that assessed the efficacy of GLP-1 analogs on glycemic control (HbA1C) over 12-56 weeks that met additional criteria, including the availability of standardized sitting BP assessment and weight parameters, were identified. Comparator therapy included oral antiglycemic drugs or placebo. The weighted mean difference (WMD) in systolic BP (SBP) change was calculated using a random-effects model after performing a test for heterogeneity. results Forty-one percent of patients were treated with liraglutide (0.3-3 mg once daily), whereas 59% were treated with exenatide (5-10 μg twice daily or 2 mg weekly). GLP-1 treatment achieved a greater SBP reduction than comparator therapy (WMD = 2.22 mm Hg; 95% confidence interval (CI) = -2.97 to -1.47). In the pooled analysis, GLP-1 had beneficial effects on weight loss (WMD = -2.56 kg; 95% CI = -3.12 to -2.00), HbA1c reduction (WMD = -0.41%; 95% CI = -0.78 to -0.04) but was associated with a heart rate increase (WMD = 1.30 bpm; 95% CI = 0.26-2.33). In a separate meta-regression analysis, the degree of SBP change was not related to baseline BP, weight loss, or improvement in HbA1C. conclusions This meta-analysis provides evidence that GLP-1 analogs reduce sitting SBP. These findings may support potentially favorable long-term cardiovascular outcomes.

AB - background Incretin therapies such as glucagon-like peptide 1 (GLP-1) agonists are commonly used for the treatment of type 2 diabetes mellitus. GLP-1 mimetics, besides improving glycemic control, have been shown to influence multiple pathways regulating blood pressure (BP). We investigated the GLP-1 analogs effects on BP from published randomized studies using a meta-analytic approach. methods Thirty-three trials (12,469 patients) that assessed the efficacy of GLP-1 analogs on glycemic control (HbA1C) over 12-56 weeks that met additional criteria, including the availability of standardized sitting BP assessment and weight parameters, were identified. Comparator therapy included oral antiglycemic drugs or placebo. The weighted mean difference (WMD) in systolic BP (SBP) change was calculated using a random-effects model after performing a test for heterogeneity. results Forty-one percent of patients were treated with liraglutide (0.3-3 mg once daily), whereas 59% were treated with exenatide (5-10 μg twice daily or 2 mg weekly). GLP-1 treatment achieved a greater SBP reduction than comparator therapy (WMD = 2.22 mm Hg; 95% confidence interval (CI) = -2.97 to -1.47). In the pooled analysis, GLP-1 had beneficial effects on weight loss (WMD = -2.56 kg; 95% CI = -3.12 to -2.00), HbA1c reduction (WMD = -0.41%; 95% CI = -0.78 to -0.04) but was associated with a heart rate increase (WMD = 1.30 bpm; 95% CI = 0.26-2.33). In a separate meta-regression analysis, the degree of SBP change was not related to baseline BP, weight loss, or improvement in HbA1C. conclusions This meta-analysis provides evidence that GLP-1 analogs reduce sitting SBP. These findings may support potentially favorable long-term cardiovascular outcomes.

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