engleski

The Antihypertensive Effect of the GLP-1 Mimetic Exenatide

Glucagon-like peptide-1 (GLP 1) is an incretin, a gastrointestinal hormone secreted from the gut after a meal. The positive glucoregulatory properties of GLP 1 are well known: it inhibits glucagon release, delays gastric emptying and augments satiety with the consequence of weight loss. The incretin mimetic exenatide, a pharmacological agent with a structure similar to that of GLP 1, has all the above properties of endogenous GLP 1. We examined 40 patients with type 2 diabetes mellitus unable to achieve adequate glycemic control with sulphonylurea and/or metformin. Patients were without antihypertensive therapy, or on stable one. Exenatide was added to therapy for 52 weeks: 5 mg of exenatide BID for the first 4 weeks, and then till the end of the study 10 mg BID. At the end of the trial, statistically significant mean reduction in both systolic blood pressure −4.65 mmHg ; p = 0.008582) and diastolic blood pressure (−1.48 mmHg ; p = 0.006286) was observed. GLP 1 receptors are found all over the body, as well as in the kidneys. Both GLP 1 and exenatide enhance sodium excretion, and their diuretic properties could explain the lowering of blood pressure. Do we have a drug that influences three elements of the metabolic syndrome: diabetes, obesity, and hypertension?

hypertension; GLP-1; diabetes mellitus

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