Lowering Blood Pressure with the Combination of a Sodium-Glucose Cotransporter 2 Inhibitor and a Glucagon-like Peptide-1 Receptor Agonist in Type 2 Diabetic Patients: A Clinical Evidence
- 65 Downloads
Patients with type 2 diabetes mellitus (T2DM) often have numerous cardiovascular risk factors, among which hypertension.
To evaluate the blood pressure variations among patients treated with a combination of a sodium-glucose cotransporter 2 inhibitor (iSGLT-2) and a glucagon-like peptide-1 receptor agonist (GLP-1ra).
We analyze 17 patients treated with this combination to quantify the changes on blood pressure by ambulatory blood pressure monitoring at baseline and at three and 6 months follow-up.
We observed a decrease of HbA1c levels (p = 0.004) at six months follow-up, a decrease in mean 24 h systolic blood pressure [from 124 (11) mmHg to 123 (4.75) mmHg, p = 0.04] and in both, mean waking and sleeping systolic blood pressure, being greater the reduction in the sleeping time [118 (20) mmHg to 111 (20) mmHg, p = 0.004].
The effect of a combination therapy of an iSGLT-2 and a GLP-1ra on blood pressure in a real-world setting, may have summative effects especially in SBP.
KeywordsAmbulatory blood pressure monitoring Diabetes Glucagon-like peptide-1 receptor agonist Sodium-glucose cotransporter 2 inhibitor
Compliance with Ethical Standards
Conflict of interest
The authors declare not having conflict of interest. Boehringer Ingelheim, ASTRA and JANSSEN laboratories supported the online database of this registry.
The study has been approved by the appropriate institutional and/or national research ethics committee (Hospital Universitario de Málaga) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- 2.Kiselev AR, Posnenkova OM, Belova OA, Romanchuk SV, Popova YV, Prokhorov MD, et al. Impact of clinical factors on the achievement of target blood pressure in hypertensive patients from Ivanovo region of Russia: data of 2015. High Blood Press Cardiovasc Prev. 2017;24:425–35.CrossRefPubMedGoogle Scholar
- 6.Fonseca VA, Deuries JH, Henry RR, Donsmark M, Thomsen HF, Plutzky J. Reduction in systolic blood pressure with Liraglutide in patients with type 2 diabetes: insights from a patient-level pooled analysis of six randomized clinical trials. J Diabetes Complications. 2014;28:399–405.CrossRefPubMedPubMedCentralGoogle Scholar
- 7.Kumarathurai P, Anholm C, Fabricius-Bjerre A, Nielsen OW, Kristiansen O, Madsbad S, et al. Effects of the glucagon-like peptide-1 receptor agonist liraglutide on 24-h ambulatory blood pressure in patients with type 2 diabetes and stable coronary artery disease: a randomized double-blind, placebo-controlled, crossover study. J Hypertens. 2017;35:1070–8.CrossRefPubMedGoogle Scholar
- 9.Lundkvist P, Pereira MJ, Katsogiannos P, Sjostrom CD, Johnsson E, Eriksson JW. Dapagliflozin once daily plus exenatide once weekly in obese adults without diabetes: sustained reductions in body weight, glycaemia and blood pressure over 1 year. Diabetes Obes Metab. 2017;19:1276–88.CrossRefPubMedPubMedCentralGoogle Scholar
- 10.Ludvik B, Frias JP, Tinahones FJ, Wainstein J, Jiang H, Robertson KE, et al. Dulaglutide as add-on therapy to SGLT2 inhibitors in patients with inadequately controlled type 2 diabetes (AWARD-10): a 24-week, randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2018;6:370–81.CrossRefPubMedGoogle Scholar