Cardiovascular and kidney benefits of SGLT-2is and GLP-1RAs according to baseline blood pressure in type 2 diabetes: a systematic meta-analysis of cardiovascular outcome trials

Oct 19, 2024Scandinavian cardiovascular journal : SCJ

Heart and kidney benefits of SGLT-2 inhibitors and GLP-1 receptor agonists vary with blood pressure in type 2 diabetes

AI simplified

GLP-1 Therapies on OpenScience ↗PubMed ↗DOI ↗OA ↗

Abstract

Seventeen publications based on 9 unique cardiovascular outcome trials were analyzed to assess the cardiorenal benefits of sodium-glucose co-transporter 2 inhibitors and glucagon-like peptide 1 receptor agonists in patients with type 2 diabetes.

In participants with normal baseline blood pressure, SGLT-2 inhibitors were associated with reduced risks for major adverse cardiovascular events, heart failure hospitalization, composite cardiovascular death/heart failure hospitalization, and composite renal outcomes.
For participants with higher baseline blood pressure, SGLT-2 inhibitors also showed similar reductions in these risks, indicating comparable benefits across blood pressure categories.
In contrast, GLP-1 receptor agonists did not demonstrate strong effects on major adverse cardiovascular events, stroke, and nephropathy in those with normal baseline blood pressure, but did reduce stroke and nephropathy risks in participants with higher baseline blood pressure.
No statistical evidence suggested that baseline blood pressure modified the cardiorenal benefits of either SGLT-2 inhibitors or GLP-1 receptor agonists.

AI simplified

Using a systematic meta-analysis, we investigated if patients with type 2 diabetes (T2D) and with varying baseline blood pressure (BP) differ in the cardiorenal benefits received from sodium-glucose co-transporter 2 inhibitors (SGLT-2is) and glucagon-like peptide 1 receptor agonists (GLP-1RAs).Randomized, placebo-controlled, cardiovascular outcome trials (CVOTs) of SGLT-2is and GLP-1RAs were identified from MEDLINE, Embase, and the Cochrane Library up to April 2024. Hazard ratios (HRs) with 95% CIs were pooled. The differential treatment effect by baseline BP category within each trial was estimated as the ratio of the HR (RHR) and pooled.Seventeen publications based on 9 unique CVOTs (4 SGLT-2is and 5 GLP-1RAs) were eligible. In participants with normal baseline BP, comparing SGLT-2is with placebo, the HRs (95% CIs) were 0.88 (0.79-0.97) for major adverse cardiovascular events (MACE), 0.73 (0.59-0.91) for heart failure (HF) hospitalization, 0.78 (0.65-0.94) for composite CVD death/HF hospitalization, and 0.55 (0.41-0.73) for composite renal outcome. The corresponding estimates for participants with higher baseline BP were 0.88 (0.81-0.96), 0.67 (0.57-0.79), 0.73 (0.65-0.82), and 0.61 (0.48-0.77), respectively. In participants with normal baseline BP, GLP-RAs had no strong effect on MACE, stroke and nephropathy, but reduced stroke and nephropathy risk in those with higher baseline BP. Estimated RHRs showed no statistical evidence that baseline BP modified the cardiorenal benefits of SGLT-2is and GLP-1RAs.In patients with T2D, the cardiorenal benefits of treatment with SGLT2-Is and GLP1-RAs were similar in patients with normal baseline BP compared to those with a higher baseline BP. Design: Results: Conclusions:

Full Text

Full text is available at the source.

View full text ↗

Cardiovascular and kidney benefits of SGLT-2is and GLP-1RAs according to baseline blood pressure in type 2 diabetes: a systematic meta-analysis of cardiovascular outcome trials

Abstract

Full Text

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief

Abstract

Full Text

Related papers

You found one interesting study. We’ll send the next 7.

what lands in your inbox each week:

Recent issues from the glp-1 therapies brief