Effects of exenatide on systolic blood pressure in subjects with type 2 diabetes

Abstract

Background: The majority of patients with type 2 diabetes mellitus have blood pressure (BP) exceeding the recommended value of 130/80mmHg. Optimal control of hyperglycemia and hypertension has been shown to reduce the incidence of macrovascular and microvascular complications due to diabetes. Treatment with the GLP-1 receptor agonist exenatide, previously demonstrated to reduce hemoglobin A 1C and weight in subjects with type 2 diabetes, was associated with BP reduction in several studies. Methods: This analysis explored the effects of exenatide vs. placebo or insulin on BP measurements in pooled data from six trials including 2,171 subjects studied for at least 6 months. Results: Overall, 6 months of exenatide treatment was associated with a significantly greater reduction in systolic BP (SBP) compared with placebo (least squares mean (s.e.): difference of 2.8mmHg (0.75); P = 0.0002) or insulin (difference of 3.7mmHg (0.85); P 0.0001). No significant intergroup differences in diastolic BP (DBP) were observed. The majority of the intergroup difference was observed in subjects with SBP 130mmHg (difference of 3.8mmHg (1.08) from placebo: P = 0.0004; difference of 4.0mmHg (1.01) from insulin; P 0.0001). The largest intertreatment differences between exenatide and comparators were observed in subjects with SBP 150mmHg. Similar responses were observed in African-American subjects. A weak correlation between the amount of weight lost and reduction in SBP was found (r = 0.09, P = 0.002) for exenatide-treated subjects. Conclusions: These Results: support the need for a prospective, randomized, controlled study of BP changes during exenatide treatment in patients with hypertension and type 2 diabetes. © 2010 American Journal of Hypertension, Ltd.