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
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
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DOI：
10.1161/hypertensionaha.114.03062
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发表时间：
2014-10-01
期刊：
影响因子：
8.3
通讯作者：
Geiger, Mary Jane
中科院分区：
文献类型：
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作者：
Ferdinand, Keith C.;White, William B.;Geiger, Mary Jane
用于治疗2型糖尿病的胰高血糖素样肽-1受体激动剂与收缩压（SBP）的小幅降低和心率的增加有关。然而，基于临床测量的结果不能充分评估药物的24小时药效学特征。每周一次的胰高血糖素样肽-1受体激动剂dullavin对血压和心率的影响通过动态血压监测进行了研究。患者（n=755; 56 +/- 10岁; 81%白色; 48%女性），患有2型糖尿病，服用≥ 1种口服降糖药物，临床血压在90/60和140/90 mm Hg之间，随机接受dullidine（1.5或0.75 mg）或安慰剂皮下注射26周。在基线和第4、16和26周进行动态血压监测。主要终点是平均24小时收缩压从基线到第16周的变化，这是一种比较dulcantine与安慰剂效果的树守门策略。在24小时收缩压和舒张压的变化方面，两种剂量的度乐宁均不劣于安慰剂，度乐宁1.5 mg显著降低收缩压（最小二乘均值差[95%置信区间]），-2.8 mmHg [-4.6，-1.0]; P
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