Magnus Wijkman, MD, PhD, and fellow researchers at multiple international centers have discovered that prescribing liraglutide for glycemic control in patients with type 2 diabetes mellitus (T2DM) may also aid in weight loss and reduction of blood pressure. Click through the slides below for details on their study and take home points for clinical practice.
Liraglutide Lowers Blood Pressure: Who Benefits Most and How?
Blood Pressure and T2DM. Authors of this study sought to identify predictors of SBP reduction by liraglutide in T2DM patients on insulin and describe the associations between SBP reduction and reductions in weight, BMI, and A1c.
The Study. This randomized, double-blind, placebo-controlled parallel group study looked at 122 patients who were given liraglutide 1.8mg/d or placebo for 24 weeks. Inclusion criteria was adults with T2DM treated with multiple daily insulin injections with or without metformin. Patients underwent masked CGM with weight, BMI, and BP measurements recorded at 6, 12, 18, and 24 weeks. The primary endpoint was change in A1c between baseline and week 24.
The Results. There was a significant decrease in SBP observed in the liraglutide group after 6 weeks of treatment and at week 24 SBP remained significantly decreased in liraglutide group vs placebo group. DBP did not change significantly for either group. SBP, DBP, serum fasting C-peptide, and mean CGM were statistically significant predictors of SBP reduction in the liraglutide group. SBP reduction correlated directly with change in body weight and BMI, but not in A1c.
Take Home Points:
- Patients with T2DM and hypertension who already use insulin may benefit from combination therapy with liraglutide.
- T2DM patients with higher baseline DBP may benefit the most from adding liraglutide to their glycemic regimen.
- Reductions in body weight and A1c may not accompany decrease in SBP with this strategy.
- Patients with better glycemic control may see greater reductions in SBP on liraglutide therapy.
- Individualized treatment plan is necessary when considering therapy in patients with hypertension and T2DM.
Perspective. “We present another study focusing on the complex interplay between independent cardiovascular risk factors and diabetes. It cannot be stressed enough how important it is to tailor treatment plans to individual patients with the cornerstone of therapy in T2DM being tight glycemic control. It is clear that liraglutide has a role to play in multiple facets of risk reduction in T2DM, but one size never fits all. Clinicians should take this new information and apply it in conjunction with established risk reduction strategies that address the unique characteristics of each patient.”
Reference: Wijkman MO, Dena M, Dahlqvist S, et al. Predictors and correlates of systolic blood pressure reduction with liraglutide treatment in patients with type 2 diabetes. J Clin Hypertens (Greenwich). 2019;21:105-115.
