Impact of glucagon-like peptide 1 receptor agonists and sodium-glucose transport protein 2 inhibitors on blood pressure and lipid profile

Expert Opin Pharmacother. 2020 Dec;21(17):2125-2135. doi: 10.1080/14656566.2020.1795132. Epub 2020 Jul 22.

Abstract

Introduction: Type 2 diabetes mellitus (T2DM) is associated with increased prevalence of cardiovascular (CV) disease (CVD). Optimal anti-hyperglycemic agents should include control of multiple CV risk factors (RF) to improve macrovascular and microvascular complications, as well as glycemia.

Areas covered: In this narrative review, the authors focus on the effects of glucagon-like peptide 1 receptor agonists (GLP-1 RA) and sodium-glucose transport protein 2 inhibitors (SGLT2i) on blood pressure (BP) and the lipid profile, two well-established CV RF.

Expert opinion: Results from recent CV outcome trials (CVOTs), showed the impact of GLP-1 RA and SGLT2i on BP and lipid levels. These classes of medication can alter cardiac function by affecting the process of atherosclerosis and/or hemodynamic status. The results of published GLP1-RA and SGLT2i CVOTs have shown multifactorial benefits; in addition to the main effects on glycemia and body weight (BW), there are also positive but moderate effects on BP and lipid levels. Full advantage of the pleiotropic benefit of these agents should be taken to prevent CV events.

Keywords: Atherosclerosis; blood pressure; glucagon-like peptide 1 receptor agonists; lipid profile; sodium-glucose transport protein 2 inhibitors.

Publication types

  • Review

MeSH terms

  • Blood Glucose / analysis
  • Blood Pressure / drug effects*
  • Cardiovascular Diseases / metabolism
  • Cardiovascular Diseases / prevention & control*
  • Diabetes Mellitus, Type 2 / blood
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetes Mellitus, Type 2 / physiopathology
  • Glucagon-Like Peptide 1 / metabolism
  • Glucagon-Like Peptide-1 Receptor / agonists*
  • Humans
  • Hypoglycemic Agents / administration & dosage
  • Hypoglycemic Agents / adverse effects
  • Hypoglycemic Agents / therapeutic use*
  • Lipids / blood*
  • Sodium-Glucose Transport Proteins / metabolism
  • Sodium-Glucose Transporter 2 Inhibitors / administration & dosage
  • Sodium-Glucose Transporter 2 Inhibitors / adverse effects
  • Sodium-Glucose Transporter 2 Inhibitors / therapeutic use*

Substances

  • Blood Glucose
  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents
  • Lipids
  • Sodium-Glucose Transport Proteins
  • Sodium-Glucose Transporter 2 Inhibitors
  • Glucagon-Like Peptide 1