Kumarathurai Preman, Anholm Christian, Fabricius-Bjerre Andreas, Nielsen Olav W, Kristiansen Ole, Madsbad Sten, Haugaard Steen B, Sajadieh Ahmad
aDepartment of Cardiology, Copenhagen University Hospital of Bispebjerg bDepartment of Internal Medicine, Copenhagen University Hospital of Amager cDepartment of Endocrinology, Copenhagen University Hospital of Hvidovre dClinical Research Center, Copenhagen University Hospital of Hvidovre, Copenhagen, Denmark.
J Hypertens. 2017 May;35(5):1070-1078. doi: 10.1097/HJH.0000000000001275.
The glucagon-like peptide-1 receptor agonist liraglutide has been shown to reduce blood pressure (BP) in clinical trials using office BP measurements. However, the effects of liraglutide on 24-h BP and on the diurnal variation in BP have not been explored sufficiently.
Forty-one patients with type 2 diabetes and stable coronary artery disease were randomized to receive liraglutide or placebo to a backbone therapy of metformin in this double-blind, placebo-controlled 12 along with 12 weeks crossover study. Ambulatory blood pressure monitoring (ABPM) was performed at the start and end of each intervention.
Twenty-four individuals completed all 24-h BP measurements. Liraglutide, when compared with placebo, did not induce any significant changes in mean 24-h SBP [difference +1.8 mmHg (95% confidence interval, 95% CI: -4.33 to 7.93)] or DBP [+4.2 mmHg (-0.74 to 9.17)]. Twenty-four-hour BP profiles revealed a trend for increase in evening SBP and DBP [+9.2 mmHg (95% CI: 1.1-17.2) and +9.7 mmHg (95% CI: 3.9-15.5), respectively]. Mean heart rate significantly increased after liraglutide [+7.6 bpm (95% CI: 2.56-12.62)]. Liraglutide did not affect the BP variability or the nocturnal BP dipping.
We could not demonstrate any BP-lowering effect of liraglutide when using 24-h ABPM. Liraglutide exhibited diurnal variation in the effect on BP without affecting the BP variability or nocturnal BP dipping.
在使用诊室血压测量的临床试验中,胰高血糖素样肽-1受体激动剂利拉鲁肽已被证明可降低血压(BP)。然而,利拉鲁肽对24小时血压及血压昼夜变化的影响尚未得到充分研究。
在这项双盲、安慰剂对照的12周平行加12周交叉研究中,41例2型糖尿病合并稳定型冠状动脉疾病患者被随机分配接受利拉鲁肽或安慰剂,并联合二甲双胍基础治疗。在每次干预开始和结束时进行动态血压监测(ABPM)。
24例个体完成了所有24小时血压测量。与安慰剂相比,利拉鲁肽并未引起24小时平均收缩压[差值+1.8 mmHg(95%置信区间,95%CI:-4.33至7.93)]或舒张压[+4.2 mmHg(-0.74至9.17)]有任何显著变化。24小时血压曲线显示夜间收缩压和舒张压有升高趋势[分别为+9.2 mmHg(95%CI:1.1-17.2)和+9.7 mmHg(95%CI:3.9-15.5)]。利拉鲁肽治疗后平均心率显著增加[+7.6次/分钟(95%CI:2.56-12.62)]。利拉鲁肽不影响血压变异性或夜间血压下降。
使用24小时ABPM时,我们未能证明利拉鲁肽有任何降压作用。利拉鲁肽对血压的影响呈现昼夜变化,且不影响血压变异性或夜间血压下降。