Engeli Stefan, Jordan Jens
Institute of Clinical Pharmacology, Hannover Medical School, Hannover, Germany.
Curr Opin Nephrol Hypertens. 2014 Sep;23(5):468-72. doi: 10.1097/01.mnh.0000449846.91046.ac.
The growing number of obese patients with a high risk of developing hypertension and type 2 diabetes mellitus requires several drugs to treat all the associated morbidities. Ideally, one drug would help to tackle several health problems at the same time. We review available information on the blood pressure-reducing effects of the new antidiabetic drug classes, glucagon-like peptide 1 analogues and sodium glucose transporter 2 inhibitors.
Blood pressure reduction with glucagon-like peptide 1 analogues or sodium glucose transporter 2 inhibitors ranges between 1 and 7 mmHg, both systolic and diastolic. As these drugs have not been sufficiently investigated in studies with office or ambulatory blood pressure as the primary efficacy measure or in prespecified hypertensive patient populations, their true efficacy in reducing blood pressure remains unclear. These studies are needed because the blood pressure-lowering effects of metabolic drugs may help to improve the clinical management of hypertensive patients with type 2 diabetes mellitus.
Obese patients with type 2 diabetes mellitus and difficult to control arterial hypertension represent a clinically important patient group at high cardiovascular risk that may profit from combined cardiovascular and metabolic actions of a drug.
肥胖患者患高血压和2型糖尿病的风险日益增加,需要多种药物来治疗所有相关的并发症。理想情况下,一种药物应能同时解决多个健康问题。我们综述了有关新型抗糖尿病药物类别(胰高血糖素样肽1类似物和钠-葡萄糖协同转运蛋白2抑制剂)降压作用的现有信息。
使用胰高血糖素样肽1类似物或钠-葡萄糖协同转运蛋白2抑制剂后,收缩压和舒张压的降低幅度在1至7mmHg之间。由于在以诊室血压或动态血压作为主要疗效指标的研究中,或在预先设定的高血压患者群体中,对这些药物的研究尚不充分,因此它们降低血压的真正疗效仍不明确。之所以需要开展这些研究,是因为代谢药物的降压作用可能有助于改善2型糖尿病高血压患者的临床管理。
患有2型糖尿病且难以控制动脉高血压的肥胖患者是临床上重要的高心血管风险患者群体,可能会从具有心血管和代谢双重作用的药物中获益。