Glucagon‐like peptide‐1 receptor agonists modestly reduced blood pressure among patients with and without diabetes mellitus: A meta‐analysis and meta‐regression

Author:

Rivera Frederick Berro1ORCID,Lumbang Grace Nooriza O.2,Gaid Danielle Rose Magno2,Cruz Linnaeus Louisse A.3,Magalong John Vincent3,Bantayan Nathan Ross B.3,Lara‐Breitinger Kyla M.4,Gulati Martha5,Bakris George6ORCID

Affiliation:

1. Department of Medicine Lincoln Medical Center New York New York USA

2. Cebu Institute of Medicine Cebu City Philippines

3. University of the Philippines College of Medicine Manila Philippines

4. Department of Cardiovascular Medicine Mayo Clinic Rochester Minnesota USA

5. Department of Cardiology, Barbra Streisand Women's Heart Center Cedars‐Sinai Smidt Heart Institute Los Angeles California USA

6. Department of Medicine University of Chicago Chicago Illinois USA

Abstract

AbstractAimThe cardiovascular benefits provided by glucagon‐like peptide‐1 receptor agonists (GLP‐1RAs) extend beyond weight reduction and glycaemic control. One possible mechanism may relate to blood pressure (BP) reduction. We aim to quantify the BP‐lowering effects of GLP1‐RAs.MethodsA comprehensive database search for placebo‐controlled randomized controlled trials on GLP‐1RA treatment was conducted until December 2023. Data extraction and quality assessment were carried out, employing a robust statistical analysis using a random effects model to determine outcomes with a mean difference (MD) in mmHg and 95% confidence intervals (CIs). The primary endpoint was the mean difference in systolic BP (SBP) and diastolic BP. Subgroup analyses and meta‐regressions were done to account for covariates.ResultsCompared with placebo, GLP‐1RAs modestly reduced SBP [semaglutide: MD −3.40 (95% CI −4.22 to −2.59, p < .001); liraglutide: MD −2.61 (95% CI −3.48 to −1.74, p < .001); dulaglutide: MD −1.46 (95% CI −2.20 to −0.72, p < .001); and exenatide: MD −3.36 (95% CI −3.63 to −3.10, p < .001)]. This benefit consistently increased with longer treatment durations. Diastolic BP reduction was only significant in the exenatide group [MD −0.94 (95% CI −1.78 to −0.1), p = .03]. Among semaglutide cohorts, mean changes in glycated haemoglobin and mean changes in body mass index were directly associated with SBP reduction.ConclusionPatients on GLP‐1RA experienced modest SBP lowering compared with placebo. This observed effect was associated with weight/body mass index reduction and better glycaemic control, which suggests that BP‐lowering is an indirect effect of GLP‐1RA and unlikely to be responsible for the benefits.

Publisher

Wiley

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