EXAMINATION OF THE EFFECT OF LIRAGLUTIDE ON BLOOD PRESSURE AND URINARY SODIUM EXCRETION

Abstract

Objective: GLP-1 analog is suitable for use in obese diabetic patients as a drug having an effect of improving postprandial blood glucose and suppressing weight loss. Recently, it has been reported that the use of this drug causes hypotension, and its mechanism is to act on the GLP-1 receptor of the proximal tubule to promote sodium excretion and increase NO production of vascular endothelium. However, few clinical reports have examined the antihypertensive effects of GLP-1 analogs. We investigated the effects of liraglutide on blood pressure and urinary sodium excretion. Design and method: The subjects were ten patients with type 2 diabetes who admitted to our department for the adjustment of the antidiabetic treatment regimen (age 66.9 ± 11.7 years, male 40%). Before introduction of liraglutide and before discharge, various tests including blood pressure and blood glucose control index and measurement of urinary sodium excretion. The dose of liraglutide was 0.3 mg/day for the first week, then increased to 0.6 mg/day, up to a maximum of 0.9 mg/day. Results: Both BMI and HbA1c (NGSP) decreased with the administration of liraglutide (BMI from 28.1 ± 3.8 to 27.0 ± 3.7, p < 0.001, HbA1c from 8.7 ± 1.5% to 7.5 ± 1.1%, p < 0.001). Urinary Na excretion increased with administration of liraglutide (frome 135.7 ± 13.71 mEq/day to 155.2 ± 30.7 mEq/day, p < 0.05). Systolic blood pressure tended to decrease in patients with hypertension (from 130.9 ± 15.0 mmHg to 124.0 ± 11.5 mmHg, p = 0.06). Conclusions: Liraglutide, a GLP-1 analog, showed an improvement in glycemic control and a weight loss effect, as well as a decrease in urinary Na excretion. The drug was considered to exhibit antihypertensive effects, particularly in cases of hypertensive complications.