Key result
Sitagliptin is linked to a ~3 mm Hg reduction in office SBP in T2D.
Why the study?
The influence of long-term sitagliptin therapy on office and home blood pressure in hypertensive patients with type 2 diabetes was unclear.
Does sitagliptin reduce blood pressure in hypertensive patients with type 2 diabetes?
Cohort (n=454)
Does sitagliptin reduce blood pressure in hypertensive patients with type 2 diabetes?
Mean Difference: -2.7
p-value: p=<0.01
Sitagliptin therapy is associated with a slight but significant reduction in blood pressure in hypertensive patients with type 2 diabetes, suggesting pleiotropic antihypertensive effects.
Modest SBP reduction may occur with sitagliptin in T2D; hypothesis-generating and should not change practice pending RCTs.
BACKGROUND: The influence of long-term sitagliptin therapy on office blood pressure (BP) and home BP has been unclear. METHODS: In a retrospective cohort study of 454 patients with type 2 diabetes, the following variables were analyzed before and at 3, 6, 9, and 12 months after initiation of sitagliptin therapy: office systolic blood pressure (SBP), office diastolic blood pressure (DBP), office pulse rate, morning home SBP, morning home DBP, morning home pulse rate, evening home SBP, evening home DBP, evening home pulse rate, hemoglobin A1c (HbA1c), plasma glucose, lipid profile, and renal function parameters. RESULTS: The office SBP showed a significant decrease after 6 and 12 months of sitagliptin therapy (P < 0.01 and P < 0.01, respectively), while office DBP was decreased significantly at all time points of evaluation (3, 6, 9, and 12 months: P < 0.05, P < 0.001, P < 0.001, and P < 0.05, respectively). Analysis of covariance revealed a significant decrease in office SBP after 6 and 12 months, as well as significant reduction of office DBP after 6 and 9 months. Morning home SBP and DBP were significantly reduced after 6 months, as was evening home DBP after 6 and 12 months, but there was no significant decrease in evening home SBP. HbA1c and plasma glucose levels were significantly reduced at all time points of evaluation. Examination of the lipid profile revealed that total cholesterol, low-density lipoprotein cholesterol, and triglycerides were also decreased at all time points of evaluation, while high-density lipoprotein cholesterol was significantly reduced after 3, 9, and 12 months. Significant reduction of the estimated glomerular filtration rate was observed after 6, 9, and 12 months, and the urinary albumin/creatinine ratio was significantly lower at 9 and 12 months. Serum creatinine was increased significantly at all time points of evaluation. CONCLUSIONS: BP was slightly but significantly reduced from 6 months after initiation of sitagliptin therapy, indicating that this antidiabetic drug has pleiotropic effects, including an antihypertensive effect.
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Yuasa et al. (2017) conducted a cohort in Type 2 diabetes (n=454). Sitagliptin vs. Baseline was evaluated on Change in office systolic blood pressure at 6 months (-2.7 mm Hg, p=<0.01). Sitagliptin therapy in patients with type 2 diabetes was associated with a significant maximum reduction in office systolic blood pressure of 2.7 mm Hg at 6 months.
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