Blood Pressure-lowering Effects of GLP-1 Receptor Agonists Exenatide and Liraglutide: A Meta-analysis of Clinical Trials
Diabetes, obesity & metabolism | 26 Feb 2013
B Wang, J Zhong, H Lin, Z Zhao, Z Yan, H He, Y Ni, D Liu and Z Zhu
AIMS: Aside from lowering blood glucose, glucagon-like peptide-1 receptor agonists (GLP-1 RA) attract much attention because of their cardioprotective effects. The aim of this study was to assess the blood pressure-lowering effects of the GLP-1 RAs exenatide and liraglutide compared with other common drugs used to treat type 2 diabetes based on randomised controlled trials including data describing complete blood pressure (BP) changes from baseline. METHODS: We searched the major databases for published or unpublished randomised controlled trials (RCTs) that had been performed in patients with type 2 diabetes and compared the effects of exenatide and liraglutide to those of other common drugs used to treat type 2 diabetes. The RCTs that included data describing BP changes between the baseline and the end of the study were selected for further analysis. RESULTS: A total of 16 RCTs that enrolled 3443 patients in the GLP-1 RA treatment group and 2417 subjects in the control group were included in this meta-analysis. The GLP-1 RA exenatide reduced systolic blood pressure (SBP) when compared with both placebo and insulin glargine, with mean differences of -5.24 mmHg and -3.46 mmHg, respectively, and with 95% confidence intervals (CI) of -6.88 to -3.59, P<0.00001, and -3.63 to -3.29, P<0.00001, respectively. Meanwhile, in the exenatide-treated group, diastolic blood pressure (DBP) was reduced by -5.91 mmHg, with a 95% CI of -7.53 to -4.28, P<0.00001 compared with the placebo group, and -0.99 mmHg with a 95% CI of -1.12 to -0.87, P<0.00001 compared with the sitagliptin group. SBP changes in this meta-analysis were assessed in the groups treated with 1.2 mg or 1.8 mg liraglutide per day. In the 1.2 mg-treated group, liraglutide treatment reduced SBP compared with placebo and glimepiride treatment, with mean differences of -5.60 mmHg and -2.38 mmHg, and 95% CIs of -5.84 to -5.36, P<0.00001 and -4.75 to -0.01, P=0.05, respectively. In the 1.8 mg-treated group, liraglutide also reduced SBP compared with placebo and glimepiride treatment with mean differences of -4.49 mmHg and -2.62 mmHg, and a 95% CI of -4.73 to -4.26, P<0.00001, and -2.91 to -2.33, P<0.00001, respectively. CONCLUSION: Treatment with the GLP-1 RAs exenatide and liraglutide reduced SBP and DBP by 1 to 5 mmHg compared with some other anti-diabetic drugs including insulin, glimepiride and placebo for patients with type 2 diabetes. GLP-1 RAs may offer an alternative therapy for these patients and will help provide extra cardiovascular benefits.
* Data courtesy of Altmetric.com