胰高血糖素样肽-1 受体激动剂对超重或肥胖患者血压的影响:随机对照试验荟萃分析。

IF 3.3 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Journal of Hypertension Pub Date : 2024-10-17 DOI:10.1097/HJH.0000000000003903
Hon Jen Wong, Keith Zhi Xian Toh, Yao Hao Teo, Yao Neng Teo, Mark Y Chan, Leonard L L Yeo, Pei Chia Eng, Benjamin Y Q Tan, Xin Zhou, Qing Yang, Mayank Dalakoti, Ching-Hui Sia
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引用次数: 0

摘要

简介:胰高血糖素样肽-1 受体激动剂是一种新型药物,在治疗 2 型糖尿病方面疗效确切,而且越来越多地用于减肥。它们可能对治疗代谢紊乱有潜在的益处;然而,在治疗高血压(BP)方面的证据却很稀少。我们对 GLP-1 RAs 降低肥胖或超重患者血压的疗效进行了系统回顾、荟萃分析和荟萃回归研究:系统检索了三个电子数据库(PubMed、EMBASE 和 CENTRAL)中从开始到 2024 年 2 月 13 日发表的随机对照试验(RCT)。采用配对荟萃分析和随机效应荟萃回归模型。固定效应元回归用于统一不同 GLP-1 RA 剂量的治疗效果:结果:我们共纳入了 30 项 RCT,研究对象包括 37 072 名患者。与安慰剂相比,GLP-1 RA 的平均收缩压 (SBP) 降低了 -3.37 mmHg [95% 置信区间 (CI) -3.95 至 -2.80],平均舒张压 (DBP) 降低了 -1.05 mmHg (95% CI -1.46 至 -0.65)。除了研究艾塞那肽的亚组之外,在糖尿病状态、GLP-1 RA的配方、随访时间和给药途径等不同亚组中,SBP和DBP的降压效果是一致的。荟萃回归结果表明,血压降低与基线特征(如年龄、男性患者比例、HbA1c、体重、体重指数和高血压患者比例)之间无明显相关性:我们的荟萃分析表明,肥胖或超重患者使用 GLP-1 RA 有明显的降压效果,且与糖尿病状态、治疗持续时间和给药途径一致。
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Effects of glucagon-like peptide-1 receptor agonists on blood pressure in overweight or obese patients: a meta-analysis of randomized controlled trials.

Introduction: Glucagon-like peptide-1 receptor agonists are novel medications with proven efficacy in treating type 2 diabetes mellitus, and are increasingly being used for weight loss. They may potentially have benefit in treating metabolic disorders; however, evidence is sparse with regards to treating high blood pressure (BP). We performed a systematic review, meta-analysis and meta-regression investigating the efficacy of GLP-1 RAs in lowering BP in obese or overweight patients.

Methods: Three electronic databases (PubMed, EMBASE, and CENTRAL) were systematically searched for randomized controlled trials (RCTs) published from inception to 13 February 2024. Pair-wise meta-analysis and random effects meta-regression models were utilized. Fixed effects meta-regression was used to unify treatment effects across different GLP-1 RA doses.

Results: We included a total of 30 RCTs with a combined population of 37 072 patients. GLP-1 RAs demonstrated a mean systolic BP (SBP) reduction of -3.37 mmHg [95% confidence interval (CI) -3.95 to -2.80] and a mean diastolic BP (DBP) reduction of -1.05 mmHg (95% CI -1.46 to -0.65) compared with placebo. This effect was consistent across subgroups for diabetic status, formulation of GLP-1 RA, follow-up duration and route of administration for both SBP and DBP, with the exception of subgroups investigating exenatide. Meta-regression suggested no significant correlation between BP reduction and baseline characteristics such as age, percentage of male patients, HbA1c, weight, BMI, and percentage of patients with hypertension.

Conclusion: Our meta-analysis suggests significant BP reduction benefits from GLP-1 RA use in obese or overweight patients, consistent across diabetic status, duration of treatment, and across route of administration.

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来源期刊
Journal of Hypertension
Journal of Hypertension 医学-外周血管病
CiteScore
7.90
自引率
6.10%
发文量
1389
审稿时长
3 months
期刊介绍: The Journal of Hypertension publishes papers reporting original clinical and experimental research which are of a high standard and which contribute to the advancement of knowledge in the field of hypertension. The Journal publishes full papers, reviews or editorials (normally by invitation), and correspondence.
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