Kennedy Cormac, Hayes Peter, Salama Sulafa, Hennessy Martina, Fogacci Federica
Department of Pharmacology and Therapeutics, School of Medicine, Trinity College Dublin, D08W9RT Dublin, Ireland.
Wellcome-HRB Clinical Research Facility, St James Hospital, D08W9RT Dublin, Ireland.
J Clin Med. 2023 Jan 18;12(3):772. doi: 10.3390/jcm12030772.
(1) Background: Recent advances in the pharmacological treatment of obesity with glucagon-like peptide-1 receptor agonists (GLP-1 RA) highlight the potential to target excess body weight to improve blood pressure (BP). This review aimed to determine the BP reduction in trials of semaglutide for weight reduction in patients without diabetes. (2) Methods: Relevant studies were identified via a search of research databases. Studies were screened to include randomized controlled trials (RCTs) of semaglutide versus a placebo in adults. Pooled and sensitivity analyses were performed, and risk of bias was assessed. (3) Results: six RCTs, with 4744 participants, were included in the final analysis. At baseline, the cohorts in these studies had a mean BP in the normotensive range. The mean difference in systolic BP was -4.83 mmHg (95% CI: -5.65 to -4.02), while that for diastolic BP was -2.45 mmHg (95% CI: -3.65 to -1.24). All included studies were of a high methodological quality. (4) Conclusions: A clinically significant reduction in BP was evident following semaglutide treatment in normotensive populations without diabetes. The effect of semaglutide in those with obesity and hypertension is as yet undetermined. Targeting excess body weight may be a novel therapeutic strategy for these patients.
(1) 背景：胰高血糖素样肽-1受体激动剂（GLP-1 RA）在肥胖症药物治疗方面的最新进展凸显了针对超重以改善血压（BP）的潜力。本综述旨在确定司美格鲁肽用于非糖尿病患者减肥试验中的血压降低情况。(2) 方法：通过检索研究数据库来识别相关研究。筛选出包括司美格鲁肽与安慰剂在成人中的随机对照试验（RCT）。进行了汇总分析和敏感性分析，并评估了偏倚风险。(3) 结果：最终分析纳入了6项RCT，共4744名参与者。在基线时，这些研究中的队列血压均值处于正常血压范围内。收缩压的平均差值为-4.83 mmHg（95%置信区间：-5.65至-4.02），舒张压的平均差值为-2.45 mmHg（95%置信区间：-3.65至-1.24）。所有纳入研究的方法学质量都很高。(4) 结论：在无糖尿病的正常血压人群中，司美格鲁肽治疗后血压出现了具有临床意义的显著降低。司美格鲁肽对肥胖和高血压患者的影响尚未确定。针对超重可能是这些患者的一种新的治疗策略。
