Jarade Candace, Zolotarova Tetiana, Moiz Areesha, Eisenberg Mark J
Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, QC, Canada.
Graduate Program in Clinical and Translational Research, McGill University, Montreal, QC, Canada.
EClinicalMedicine. 2024 Aug 15;75:102789. doi: 10.1016/j.eclinm.2024.102789. eCollection 2024 Sep.
Despite the availability of a wide range of antihypertensive agents, a significant proportion of individuals with resistant hypertension (RHTN) struggle to achieve blood pressure (BP) control. Obesity ranks among the most significant modifiable risk factors for RHTN, with 56-91% of patients with RHTN classified as overweight or obese. Glucagon-like peptide-1 receptor agonist (GLP-1 RAs) are a class of anti-obesity medications that have recently demonstrated efficacy in reducing BP and improving cardiovascular (CV) outcomes in individuals with overweight or obesity. Among the available GLP-1-based therapies, liraglutide, semaglutide, and tirzepatide have been approved for chronic weight management in this population. Tirzepatide, a dual GLP-1 and glucose-dependent insulinotropic polypeptide receptor agonist, has the greatest effect on weight loss and BP reduction compared to GLP-1 RAs alone. To our knowledge, no trials have directly evaluated the effect of GLP-1 RAs or dual GLP-1/GIP receptor agonists on RHTN management. In this review article, we propose that targeting weight loss through GLP-1-based therapies should be explored as a treatment option for individuals with RHTN who are overweight or obese.
尽管有多种抗高血压药物可供使用，但相当一部分顽固性高血压（RHTN）患者仍难以实现血压（BP）控制。肥胖是RHTN最重要的可改变风险因素之一，56%至91%的RHTN患者被归类为超重或肥胖。胰高血糖素样肽-1受体激动剂（GLP-1 RAs）是一类抗肥胖药物，最近已证明其在降低超重或肥胖个体的血压和改善心血管（CV）结局方面具有疗效。在现有的基于GLP-1的治疗方法中，利拉鲁肽、司美格鲁肽和替尔泊肽已被批准用于该人群的慢性体重管理。与单独使用GLP-1 RAs相比，替尔泊肽是一种双重GLP-1和葡萄糖依赖性促胰岛素多肽受体激动剂，对体重减轻和血压降低的效果最大。据我们所知，尚无试验直接评估GLP-1 RAs或双重GLP-1/GIP受体激动剂对RHTN管理的影响。在这篇综述文章中，我们建议对于超重或肥胖的RHTN患者，应探索通过基于GLP-1的治疗方法来减轻体重，作为一种治疗选择。
