Dulaglutide 1.5 mg shows both a weight reduction dependent and a greater weight reduction independent decrease in both pulse pressure and systolic blood pressure (SBP), according to a recent study in Cardiovascular Diabetology.
The study investigators performed a meta-analysis on 6 randomized, double-blind trials that evaluated dulaglutide 1.5 mg in patients with type 2 diabetes. They included studies that measured sitting SBP and diastolic blood pressure (DBP) from approximately 6 months into treatment (weeks 24-26). The data were pooled in a random-effect model and then evaluated for both weight-dependent and weight-independent changes in SBP, DBP, and pulse pressure.
The study populations were composed of participants with a mean age of 54 to 58 years. They were 44% to 59% men and 51% to 89% White. Of the patients, 59% to 72% had a diagnosis of hypertension.
The studies showed a decrease of 2.6 mm Hg in SBP compared with the placebo. Thirty-six percent of this effect was weight-dependent and 64% was weight-independent. Pulse pressure decreases were 2.5 mm Hg. Fourteen percent of the effect was weight-dependent, and 86% was weight-independent.
DBP did not show the same improvement with the use of dulaglutide 1.5 mg, as the weight-dependent changes were small (-0.9 to 1.1 mm Hg). There was no statistically significant change in weight-independent DBP.
The investigators noted that there are several possible mechanisms for the effects of dulaglutide on the cardiovascular system; GLP-1 receptor activation reduces endothelial-induced contractions of vascular smooth muscle and increases endothelial-dependent relaxation.
According to investigators, the findings in this study varied slightly from other studies in that the weight-independent effects were more pronounced. The authors postulated that the differences could be related to the more narrow time point variation that they evaluated compared with other meta-analyses.
“Understanding the mechanisms by which dulaglutide improves SBP and pulse pressure, whether dependent or independent of weight reduction, could provide insight into developing future treatment regimens for elevated blood pressure,” the study authors wrote.
Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.
Ferdinand KC, Dunn J, Nicolay C, Sam F, Blue EK, Wang H. Weight-dependent and weight-independent effects of dulaglutide on blood pressure in patients with type 2 diabetes. Cardiovasc Diabetol. Published online March 9, 2023. doi:10.1186/s12933-023-01775-x