Semaglutide and blood pressure: an individual patient data meta-analysis.

Autor:	Kennedy C; Department of Pharmacology and Therapeutics, School of Medicine, Trinity College Dublin, Dublin D02 PN40, Ireland.; Wellcome-HRB Clinical Research Facility, St James's Hospital, Dublin D08 NHY1, Ireland., Hayes P; Health Research Institute, University of Limerick, Ireland., Cicero AFG; Hypertension and Cardiovascular Risk Research Unit, Department of Medical and Surgical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy.; Cardiovascular Medicine Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy., Dobner S; 3rd Medical Department of Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria., Le Roux CW; Diabetes Complications Research Centre, Conway Institute, University College Dublin, Dublin, Ireland., McEvoy JW; University of Galway and National Institute of Prevention and Cardiovascular Health, Galway, Ireland., Zgaga L; Department of Public Health and Primary Care, School of Medicine, Trinity College Dublin, Ireland., Hennessy M; Department of Pharmacology and Therapeutics, School of Medicine, Trinity College Dublin, Dublin D02 PN40, Ireland.; Wellcome-HRB Clinical Research Facility, St James's Hospital, Dublin D08 NHY1, Ireland.
Jazyk:	angličtina
Zdroj:	European heart journal [Eur Heart J] 2024 Oct 07; Vol. 45 (38), pp. 4124-4134.
DOI:	10.1093/eurheartj/ehae564
Abstrakt:	Background and Aims: Randomized clinical trials (RCTs) assessing semaglutide reported reductions of systolic blood pressure (SBP) in trial populations with baseline blood pressure in the normotensive range. This study aimed to determine whether this SBP reduction is greater in hypertensive groups. Methods: Individual patient data (IPD) from three RCTs examining the effect of semaglutide 2.4 mg on body weight over 68 weeks were included. Trial participants were categorized according to a hypertension diagnosis, treatment or baseline measurement (HTN), baseline SBP > 130 mmHg (HTN130) or >140 mmHg (HTN140), and those with apparent resistant hypertension (RH). The primary analysis compared the in-trial change in SBP in the semaglutide and placebo arms. Alterations of anti-hypertensive medications were quantified by treatment intensity score and compared between arms. These analyses were performed using analysis of covariance. Results: Overall, 3136 participants were included. The difference in SBP change between the treatment (n = 2109) and placebo (n = 1027) groups was -4.95 mmHg [95% confidence interval (CI) -5.86 to -4.05] overall. This difference was -4.78 mmHg (95% CI -5.97 to -3.59) for HTN, -4.93 mmHg (95% CI -6.75 to -3.11) for HTN130, -4.09 mmHg (95% CI -7.12 to -1.06) for HTN140, and -3.16 mmHg (95% CI -8.69-2.37) for RH. Reduction in SBP was mediated substantially by weight loss. The anti-hypertensive treatment intensity score decreased for those on semaglutide compared to placebo (-0.51; 95% CI -0.71 to -0.32). Conclusions: This IPD analysis of three large RCTs found blood pressure reductions with semaglutide in participants with hypertension that were similar to those seen in all trial participants. This finding may in part be due to concurrent reductions to anti-hypertensive medications. These results suggest that semaglutide is a useful adjunctive treatment for patients with hypertension and obesity. (© The Author(s) 2024. Published by Oxford University Press on behalf of the European Society of Cardiology.)
Databáze:	MEDLINE
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