Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown to reduce blood pressure in some clinical trials. Only a few studies have examined the effect of GLP-1 RAs on the 24-h variation of blood pressure. In this study, we explored the effect of the GLP-1 RA liraglutide on 24-h blood pressure and heart rate (HR) variation in patients with type 2 diabetes (T2DM) and coronary artery disease (CAD).Design and method:
Forty-one subjects were randomized to liraglutide plus metformin or placebo plus metformin in this this double-blind, placebo-controlled 12 plus 12 weeks cross-over study. Subjects underwent 24-h ambulatory blood pressure monitoring at start and end of each period.Results:
Twenty-four subjects completed all ambulatory blood pressure measurements. Liraglutide, when compared to placebo, did not induce any significant changes in mean 24-h systolic (+1.8 mmHg, p = 0.549; 95% CI: −4.3 to 7.9) or diastolic blood pressure (+4.2 mmHg, p = 0.09; 95% CI [−0.7 to 9.2]. Evening (7 pm to 12 pm) systolic and diastolic blood pressure was elevated after liraglutide treatment as compared to placebo (+9.2 mmHg, p = 0.028; 95% CI [1.1. to 17.2] and +9.7 mmHg, p = 0.002; 95% CI [3.9 to 15.5], respectively). Changes in blood pressure were not correlated to changes in weight during liraglutide or placebo. Mean HR was significantly increased (+7.6 bpm; p = 0.005; 95% CI: 2.6 to 12.6).Conclusions:
In patients with T2DM and CAD, 12 weeks of liraglutide treatment increased 24-h mean HR, but did not change mean diurnal blood pressure significantly as compared to placebo. However, liraglutide lead to significantly higher evening systolic and diastolic blood pressure as compared to placebo. The pathophysiological explanation for this observation needs to be explored in further studies.