Effects of HbA1c and weight reduction on blood pressure in patients with type 2
diabetes mellitus treated with exenatide*.
Author(s): Paul S, Best J, Klein K, Han J, Maggs D.
Affiliation(s): Queensland Clinical Trials & Biostatistics Centre, School of Population Health,
The University of Queensland, Brisbane, Queensland, Australia.
s.paul@sph.uq.edu.au
Publication date & source: 2012, Diabetes Obes Metab. , 14(9):826-34
AIM: Treatment of patients with type 2 diabetes with glucagon-like peptide-1
(GLP-1) receptor agonist exenatide has showed improvements in glycaemic control
coupled with weight loss and lowered blood pressure (BP). We examined the synergy
between improved glycaemia and weight loss on BP reduction in patients treated
with either exenatide twice daily (BID) or once weekly (QW).
METHODS: Combining data from three controlled trials, 686 (53% male) patients
[baseline mean ± SD: age 55 ± 10 years, weight 95 ± 20 kg, systolic blood
pressure (SBP)/diastolic blood pressure (DBP) 130/79 ± 15/9 mmHg, HbA(1c) 8.3 ±
1.1%] treated with exenatide QW (n = 541) or BID (n = 145) were observed over 26
weeks. Using weighted means (WMs) of the longitudinal measures of HbA(1c) and
weight, patients were subdivided into four groups at each visit by glycaemic and
weight responses; patients who failed to reduce both HbA(1c) and weight below WMs
became the reference group (R). The other three groups corresponded to patients
with HbA(1c) reduction (A), weight reduction (W) and both HbA(1c) and weight
reduction (AW).
RESULTS: Compared with R, patients in AW, A and W groups had a significantly
higher likelihood of improving SBP <130 mmHg by 88, 30 and 61%, respectively.
Compared with R, patients in AW, A and W had 63, 13 and 45% higher likelihood of
improving DBP <80 mmHg.
CONCLUSION: Although the mechanism of BP-lowering effect of exenatide is not
established, it appears that the short-term dynamics of BP is related to
concomitant effects on glycaemia and body weight. These data offer a preliminary
insight into the possible cardiometabolic effects of GLP-1 receptor agonism.
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