PP.19.07

Abstract

Objective: Glucagon-like peptide-1 (GLP-1) agonists are increasingly used in the management of type 2 diabetes mellitus (T2DM), but their long-term cardiovascular safety is not yet confirmed. Therapy with GLP-1 receptor agonist liraglutide has been associated with improvements in blood pressure but also with higher increases in heart rate (HR) compared to other GLP-1 receptor agonists. In the present study, we assessed effects of liraglutide on systolic blood pressure (SBP), diastolic blood pressure (DBP) and HR in overweight T2DM. Design and method: A total of 42 overweight T2DM with normal or mildly decreased (estimated GFR > 60 mlmin-11.73 m2) renal function were included in this study and followed for 7 months (age 58 ± 7 years, 18 M/24F, body mass index (BMI) 38.5 ± 5.6 kg/m2, weight 111 ± 21 kg, HbA1c 8.1 ± 0.9%, duration of diabetes 13 ± 6 years, serum creatinine 71 ± 15 μmol/L, estimated GFR 90 ± 13 mlmin-11.73m2). Blood pressure was measured twice in the sitting position with a mercury sphygmomanometer after a resting period of 10 minutes. HR was determined using a standard 12-lead ECG after a resting period of 10 minutes. Liraglutide was started as 0.6 mg once daily dose and increased to 1.2 mg once daily after one week. Results: Treatment with liraglutide caused a significant decrease in BMI from 38 ± 5 to 36 ± 6 kg/m2 (p < 0.001), weight from 111 ± 21 to 106 ± 23 kg (p < 0.001), and waist circumference from 120 ± 14 to 114 ± 15 cm (p = 0.006), while HbA1c (from 8.1 ± 0.9 to 8.0 ± 1.3% (p = 0.1)) did not significantly changed. However, the 7-months administration of liraglutide caused a significant decrease in SBP from 145 ± 20 to 135 ± 18 mmHg (p = 0.005) and DBP from 88 ± 8 to 82 ± 8 mmHg (p < 0.001), while HR (from 78 ± 14 to 73 ± 8 beats/min (p = 0.2)) did not significantly changed. Conclusions: The results of our study suggest that therapy with GLP-1 receptor agonist liraglutide may significantly reduce SBP and DBP by 6 to 10 mmHg and may offer an alternative therapy for hypertension in overweight T2DM. In addition, in our study therapy with liraglutide was associated with a small decrease in HR.