Effects of the once-weekly glucagon-like peptide-1 receptor agonist dulaglutide on ambulatory blood pressure and heart rate in patients with type 2 diabetes mellitus.

Hypertension

From the Tulane University School of Medicine, New Orleans, LA (K.C.F.); Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington (W.B.W.); University of Alabama at Birmingham (D.A.C.); McMaster University, Hamilton, Ontario, Canada (E.M.L.); Sager Consulting, San Francisco, CA (P.T.S.); B2S Consulting, Carmel, IN (R.B.); and Lilly Diabetes, Eli Lilly and Company, Indianapolis, IN (H.H.J., R.J.T., K.E.R., M.J.G.).

Published: October 2014

Glucagon-like peptide-1 receptor agonists, used to treat type 2 diabetes mellitus, are associated with small reductions in systolic blood pressure (SBP) and increases in heart rate. However, findings based on clinic measurements do not adequately assess a drug's 24-hour pharmacodynamic profile. The effects of dulaglutide, a once-weekly glucagon-like peptide-1 receptor agonist, on BP and heart rate were investigated using ambulatory BP monitoring. Patients (n=755; 56±10 years; 81% white; 48% women), with type 2 diabetes mellitus, taking ≥1 oral antihyperglycemic medication, with a clinic BP between 90/60 and 140/90 mm Hg were randomized to dulaglutide (1.5 or 0.75 mg) or placebo subcutaneously for 26 weeks. Ambulatory BP monitoring was performed at baseline and at 4, 16, and 26 weeks. The primary end point was change from baseline to week 16 in mean 24-hour SBP, a tree gatekeeping strategy compared the effects of dulaglutide to placebo. Both doses of dulaglutide were noninferior to placebo for changes in 24-hour SBP and diastolic blood pressure, and dulaglutide 1.5 mg significantly reduced SBP (least squares mean difference [95% confidence interval]), -2.8 mm Hg [-4.6, -1.0]; P≤0.001). Dulaglutide 0.75 mg was noninferior to placebo (1.6 bpm; [0.3, 2.9]; P≤0.02) for 24-hour heart rate (least squares mean difference [95% confidence interval]), but dulaglutide 1.5 mg was not (2.8 bpm [1.5, 4.2]). Dulaglutide 1.5 mg was associated with a reduction in 24-hour SBP and an increase in 24-hour heart rate. The mechanisms responsible for the observed effects remain to be clarified.

Download full-text PDF

Source
http://dx.doi.org/10.1161/HYPERTENSIONAHA.114.03062DOI Listing

Publication Analysis

Top Keywords

heart rate
20
glucagon-like peptide-1
12
peptide-1 receptor
12
blood pressure
12
type diabetes
12
diabetes mellitus
12
24-hour sbp
12
dulaglutide
9
once-weekly glucagon-like
8
receptor agonist
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!