Abstract P515: Vascular Stiffness is Not Changed by Dipeptidyl Peptidase 4 Inhibitor

Abstract

Introduction: The action of dipeptidyl peptidase-4 (DPP-4) inhibitors on blood pressure (BP) and arterial stiffness is controversial. This study aimed to investigate the effects of DPP-4 inhibitor (vildagliptin) on the BP and arterial stiffness. Methods: Fifty patients over 35 years of age with diabetes and hypertension without cardiovascular disease were randomized to vildagliptin (n=25) or glibenclamide (n=25) in a prospective, open, drug-controlled study. Both groups used metformin and renin angiotensin system blockers. BP was evaluated by digital sphygmomanometer and by 24-hour ambulatory BP monitoring with the Mobil-O-Graph PWA® device, which analyzes parameters of arterial stiffness (central systolic BP, pulse wave velocity (PWV) and augmentation index (AIx75). Laboratory evaluation (glycemia and glycated hemoglobin), and BP and arterial stiffness measurements were performed before and after 12 weeks of treatment. Results: Glycated hemoglobin reduced non-significantly with treatment in both groups. 24-hour systolic BP decreased significantly in the vildagliptin (123.8±12.5 vs 119.1 ± 1.7 mmHg, P=0.03) and glibenclamide group (125.1 ± 12.2 vs 117.3 ± 8.0 mmHg, P=0.002), but without difference between the groups. There were no changes in central systolic BP and PWV in the vildagliptin group before and after treament. However, in the glibenclamide group, central systolic BP decreased (116.4±12.19 vs 109.0±7.5, mmHg P=0.003), as well as PWV (8.5±1.3 vs 8.1±1.1 m/s, P=0.003), but with no difference between groups (P=0.27 and 0.32, respectively). There was also no difference for 24 hour AIx75 for both drugs. Pearson’s correlation did not demonstrate a correlation of glycemic control with PWV and AIx75. However, office systolic BP and central pulse pressure showed correlation with PWV in the vildagliptin group (P=0.008 and 0.002, respectively) and glibenclamide (P<0.001 and 0.001, respectively). Conclusions: Vildagliptin does not alter BP and arterial stiffness in diabetic and hypertensive patients. The observed improvement in 24-hour BP is due the antihypertensive treatment, as it was demonstrated in the 2 groups. Unlike blood glucose, BP correlates to arterial stiffness.