Key result
GLP-1RAs did not significantly decrease 24-hour systolic blood pressure compared to control in patients with T2DM (MD -1.57 mm Hg; 95% CI, -4.12 to 0.98).
Why the study?
Hypertension worsens cardiovascular risk in T2DM with suboptimal control rates, prompting evaluation of the effect of pleiotropic GLP-1 receptor agonists on ambulatory blood pressure.
Do glucagon-like peptide-1 receptor agonists reduce 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus?
Meta-Analysis
Do glucagon-like peptide-1 receptor agonists reduce 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus?
Mean Difference: -1.57 (95% CI -4.12–0.98)
GLP-1 receptor agonists do not significantly alter 24-hour ambulatory blood pressure in patients with type 2 diabetes mellitus.
GLP-1RAs show no ABPM effect in T2DM; challenges presumed pleiotropic BP benefits and confirms neutral ambulatory findings from RCTs.
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; I2 = 63%) and in 24-h DBP (mean difference = 1.28 mmHg; 95% CI,-0.31 to 2.87; I2 = 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.
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Patoulias et al. (2021) conducted a meta-analysis in Type 2 diabetes mellitus. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) vs. Placebo or active control was evaluated on 24-hour systolic blood pressure (MD -1.57, 95% CI -4.12 to 0.98). GLP-1RAs did not significantly decrease 24-hour systolic blood pressure compared to control in patients with T2DM (MD -1.57 mm Hg; 95% CI, -4.12 to 0.98).
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