Abstract
In press
Background. Arterial Hypertension (AH), in combination with OBesity (OB), significantly increases cardiometabolic risk, leading to the development of cardiovascular events, chronic kidney disease, and metabolic disorders. In such patients, the effectiveness of standard antihypertensive therapy may be insufficient, which requires the use of drugs with pleiotropic action.
Aim. To assess the effectiveness of liraglutide, Glucagon-Like Peptide-1 Receptors Agonist (GLP-1RA), as a component of combination therapy in patients with AH and OB, with the determination of its effect on cardiometabolic status, functional state of the kidneys, heart and neurohumoral regulation.
Materials and Methods. The study involved 62 patients with AH and OB who received liraglutide at a dose of up to 3.0 mg/day for 12 months. The dynamics of anthropometric, biochemical, hormonal, hemodynamic, and echocardiographic parameters were assessed. Statistical processing was performed using the Statistica 13.0 package (StatSoft Inc., USA).
Results. During the treatment, a significant decrease in systolic and diastolic blood pressure, body mass index, insulin levels, leptin, Cardiotrophin-1 (CTF-1), N-terminal propeptide of brain natriuretic hormone (NT-proBNP), as well as an improvement in the lipid profile were observed. According to echocardiography, regression of myocardial hypertrophy and improved systolic and diastolic function of the left ventricle was recorded. Positive but insignificant dynamics of functional renal parameters were noted.
Conclusions. Liraglutide demonstrates a pronounced multicomponent efficacy in patients with hypertension and obesity, reducing leptin resistance and improving neuroendocrine regulation and metabolic and hemodynamic profile. Our findings suggest that it can be used in complex therapy to modify cardiometabolic risk.
Keywords: leptin, GLP-1RA, N-terminal propeptide of brain natriuretic hormone, cardiohemodynamics.
References
Seravalle G, Grassi G. Obesity and hypertension. Pharmacol Res. 2017;122:1-7. DOI: 10.1016/j.phrs.2017.05.013. PMID: 28532816.
Cohen JB. Hypertension in Obesity and the Impact of Weight Loss. Curr Cardiol Rep. 2017;19(10):98. DOI: 10.1007/s11886-017-0912-4. PMID: 28840500.
Powell-Wiley TM, Poirier P, Burke LE, Despres JP, Gordon-Larsen P, Lavie CJ, et al.; American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; Council on Clinical Cardiology; Council on Epidemiology and Prevention; and Stroke Council. Obesity and Cardiovascular Disease: A Scientific Statement from the American Heart Association. Circulation. 2021;143(21):e984-1010. DOI: 10.1161/CIR.0000000000000973. PMID: 33882682.
Koenen M, Hill MA, Cohen P, Sowers JR. Obesity, Adipose Tissue and Vascular Dysfunction. Circ Res. 2021 Apr 2;128(7):951-68. DOI: 10.1161/CIRCRESAHA.121.318093. Epub 2021 Apr 1. PMID: 33793327.
Bray GA, Frühbeck G, Ryan DH, Wilding JP. Management of obesity. Lancet. 2016;387(10031):1947-56. DOI: 10.1016/S0140-6736(16)00271-3. PMID: 26868660.
Trujillo JM, Nuffer W, Smith BA. GLP-1 receptor agonists: an updated review of head-to-head clinical studies. Ther Adv Endocrinol Metab. 2021;12:2042018821997320. DOI: 10.1177/2042018821997320. PMID: 33767808.
Sandsdal RM, Juhl CR, Jensen SBK, Lundgren JR, Janus C, Blond MB, et al. Combination of exercise and GLP-1 receptor agonist treatment reduces severity of metabolic syndrome, abdominal obesity, and inflammation: a randomized controlled trial. Cardiovasc Diabetol. 2023;22(1):41. DOI: 10.1186/s12933-023-01765-z. PMID: 36841762.
Mikhail N. Cardiovascular Effects of Liraglutide. Curr Hypertens Rev. 2019;15(1):64-9. DOI: 10.2174/1573402114666180507152620. PMID: 29737256.
Neeland IJ, Marso SP, Ayers CR, Lewis B, Oslica R, Francis W, et al. Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial. Lancet Diabetes Endocrinol. 2021;9(9):595-605. DOI: 10.1016/S2213-8587(21)00179-0. PMID: 34358471.
Elkind-Hirsch KE, Chappell N, Shaler D, Storment J, Bellanger D. Liraglutide 3 mg on weight, body composition, and hormonal and metabolic parameters in women with obesity and polycystic ovary syndrome: a randomized placebo-controlled-phase 3 study. Fertil Steril. 2022;118(2):371-81. DOI: 10.1016/j.fertnstert.2022.04.027. PMID: 35710599.
Buse JB, Bain SC, Mann JFE, Nauck MA, Nissen SE, Pocock S, et al; LEADER Trial Investigators. Cardiovascular Risk Reduction with Liraglutide: An Exploratory Mediation Analysis of the LEADER Trial. Diabetes Care. 2020;43(7):1546-52. DOI: 10.2337/dc19-2251. PMID: 32366578.
Davies MJ, Aronne LJ, Caterson ID, Thomsen AB, Jacobsen PB, Marso SP; Satiety and Clinical Adiposity - Liraglutide Evidence in individuals with and without diabetes (SCALE) study groups. Liraglutide and cardiovascular outcomes in adults with overweight or obesity: A post hoc analysis from SCALE randomized controlled trials. Diabetes Obes Metab. 2018;20(3):734-9. DOI: 10.1111/dom.13125. PMID: 28950422.
Neeland IJ, Marso SP, Ayers CR, Lewis B, Oslica R, Francis W, et al. Effects of liraglutide on visceral and ectopic fat in adults with overweight and obesity at high cardiovascular risk: a randomised, double-blind, placebo-controlled, clinical trial. Lancet Diabetes Endocrinol. 2021;9(9):595-605. DOI: 10.1016/S2213-8587(21)00179-0. PMID: 34358471.
Ard J, Fitch A, Fruh S, Herman L. Weight Loss and Maintenance Related to the Mechanism of Action of Glucagon-Like Peptide 1 Receptor Agonists. Adv Ther. 2021;38(6):2821-39. DOI: 10.1007/s12325-021-01710-0. PMID: 33977495.
Angelidi AM, Kokkinos A, Sanoudou D, Connelly MA, Alexandrou A, Mingrone G, Mantzoros CS. Early metabolomic, lipid and lipoprotein changes in response to medical and surgical therapeutic approaches to obesity. Metabolism. 2023;138:155346. DOI: 10.1016/j.metabol.2022.155346. PMID: 36375643.
Papamargaritis D, Al-Najim W, Lim JZM, Crane J, Bodicoat DH, Barber S, et al. Effectiveness of integrating a pragmatic pathway for prescribing liraglutide 3.0 mg in weight management services (STRIVE study): a multicentre, open-label, parallel-group, randomized controlled trial. Lancet Reg Health Eur. 2024;39:100853. DOI: 10.1016/j.lanepe.2024.100853. PMID: 38803628.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.