Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials

May 11, 2024American journal of cardiovascular drugs : drugs, devices, and other interventions

Heart Health Benefits of GLP-1 Drugs in People with Obesity or Overweight

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Abstract

A total of 30,512 patients in 13 trials showed that GLP-1 receptor agonists reduced systolic blood pressure by 4.76 mmHg compared to placebo.

GLP-1 receptor agonists also lowered diastolic blood pressure by 1.41 mmHg compared to placebo.
These agents significantly reduced the occurrence of myocardial infarction by 28%.
No significant differences were found in the rates of unstable angina, stroke, atrial fibrillation, or deep vein thrombosis between the GLP-1 RA and placebo groups.
The findings suggest potential benefits of GLP-1 receptor agonists for cardiovascular health in patients with obesity or overweight.

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BACKGROUND: GLP-1 receptor agonists (GLP-1 RAs) have emerged as an effective therapeutic class for weight loss. However, the efficacy of these agents in reducing cardiovascular endpoints among patients living with obesity or overweight is unclear.

METHODS: We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) comparing GLP-1 RAs versus placebo in patients with obesity or overweight. We searched PubMed, Cochrane, and Embase databases. A random-effects model was used to calculate risk ratios (RRs) and mean differences (MDs), with 95% confidence intervals (CIs).

RESULTS: A total of 13 RCTs were included, with 30,512 patients. Compared with placebo, GLP-1 RAs reduced systolic blood pressure (MD - 4.76 mmHg; 95% CI - 6.03, - 3.50; p < 0.001; I= 100%) and diastolic blood pressure (MD - 1.41 mmHg; 95% CI - 2.64, - 0.17; p = 0.03; I= 100%). GLP-1 RA significantly reduced the occurrence of myocardial infarction (RR 0.72; 95% CI 0.61, 0.85; p < 0.001; I= 0%). There were no significant differences between groups in unstable angina (UA; RR 0.84; 95% CI 0.65, 1.07; p = 0.16; I= 0%), stroke (RR 0.91; 95% CI 0.74, 1.12; p = 0.38; I= 0%), atrial fibrillation (AF; RR 0.49; 95% CI 0.17, 1.43; p = 0.19; I= 22%), and deep vein thrombosis (RR 0.30; 95% CI 0.06, 1.40; p = 0.13; I= 0%). 2 2 2 2 2 2 2

CONCLUSIONS: In patients living with obesity or overweight, GLP-1 RA reduced systolic and diastolic blood pressure and the occurrence of myocardial infarction, with a neutral effect on the occurrence of UA, stroke, AF, and deep vein thrombosis.

REGISTRATION: PROSPERO identifier number CRD42023475226.

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Cardiovascular Benefits of GLP-1 Receptor Agonists in Patients Living with Obesity or Overweight: A Meta-analysis of Randomized Controlled Trials

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