Why the study?
DPP4 inhibitors may increase the risk of heart failure, and decreased degradation of vasoactive peptides like substance P could contribute; this study tested whether DPP4 inhibition and ACE inhibition interactively affect vasoactive peptides after a mixed meal.
Does sitagliptin alter postprandial vasoactive peptides in patients with type 2 diabetes and hypertension treated with RAAS inhibitors?
Does sitagliptin alter postprandial vasoactive peptides in patients with type 2 diabetes and hypertension treated with RAAS inhibitors?
DPP4 inhibition increases postprandial norepinephrine during RAAS inhibition via a substance P-dependent mechanism, providing a potential mechanism for the increased heart failure risk associated with these agents.
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May warrant HF caution with sitagliptin plus RAAS inhibitors; confirms substance P-dependent mechanism in RCT.
Wilson et al. (2019) studied this question.