Effects of HbA(1c) and weight reduction on blood pressure in patients with type 2 diabetes mellitus treated with exenatide

Paul, S., Best, J., Klein, K., Han, J. and Maggs, D. (2012) Effects of HbA(1c) and weight reduction on blood pressure in patients with type 2 diabetes mellitus treated with exenatide. Diabetes, Obesity and Metabolism, 14 9: 826-834. doi:10.1111/j.1463-1326.2012.01609.x

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Author Paul, S.
Best, J.
Klein, K.
Han, J.
Maggs, D.
Title Effects of HbA(1c) and weight reduction on blood pressure in patients with type 2 diabetes mellitus treated with exenatide
Formatted title
Effects of HbA1c and weight reduction on blood pressure in patients with type 2 diabetes mellitus treated with exenatide
Journal name Diabetes, Obesity and Metabolism   Check publisher's open access policy
ISSN 1462-8902
1463-1326
Publication date 2012-09
Sub-type Article (original research)
DOI 10.1111/j.1463-1326.2012.01609.x
Volume 14
Issue 9
Start page 826
End page 834
Total pages 9
Place of publication Oxford, United Kingdom
Publisher Wiley-Blackwell Publishing
Collection year 2013
Language eng
Formatted abstract
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, HbA1c 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 HbA1c and weight, patients were subdivided into four groups at each visit by glycaemic and weight responses; patients who failed to reduce both HbA1c and weight below WMs became the reference group (R). The other three groups corresponded to patients with HbA1c reduction (A), weight reduction (W) and both HbA1c 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.
Keyword Blood pressure
GLP-1 receptor agonist
Glycaemic control
Weight reduction
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ
Additional Notes Article first published online: 16 MAY 2012

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2013 Collection
School of Public Health Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
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Created: Tue, 15 May 2012, 14:46:46 EST by Sanjoy Paul on behalf of School of Public Health