Evidence map›GLP-1 receptor agonists × blood pressure›PMID 26358202›Full record

SynthesisDiabetes research and clinical practice2015

Impact of GLP-1 receptor agonists on blood pressure, heart rate and hypertension among patients with type 2 diabetes: A systematic review and network meta-analysis.

Feng Sun, Shanshan Wu, Shuxia Guo, Kai Yu, Zhirong Yang, Lishi Li, Yuan Zhang, Xiaochi Quan, Linong Ji, Siyan Zhan

Abstract readSystematic ReviewNetwork Meta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Diabetes research and clinical practice, 2015. The graph read 7 numbers from its abstract, feeding 2 cells of the map: it supports the treatment in 1. Cited by 141 papers, 16 of them syntheses that pooled it.

7numbers the graph read from it
1cell of the map it votes in
141citing papers in PubMed, 16 pooled it
15.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

Ratios

← favours the treatmentfavours the comparator →
0.250.51 · no effect
Incident hypertensionexenatide-10 μg-twice-daily vs sulfonylureasfavours the treatment · hypertension, t2dfeeds one cell of the map
OR 0.400.16 to 0.82
No significant association between incident hypertension and GLP-1RAs was detected, except for the association between exenatide-10 μg-twice-daily and sulfonylureas (OR, 0.40, 95% CI: 0.16, 0.82).

The authors add: No significant association between incident hypertension and GLP-1RAs was detected

FeedsGLP-1 receptor agonists×blood pressure

Differences

← favours the treatmentfavours the comparator →
-7.180 · no effect
Systolic blood pressureGLP-1RAs vs placebo, insulin, and sulfonylureasfavours the treatment · hypertension, t2dfeeds one cell of the map
Δ -4.60-7.18 to -2.03
Compared with placebo, insulin, and sulfonylureas, GLP-1RAs decreased systolic blood pressure with range from -1.84 mmHg (95% CI: -3.48 to -0.20) to -4.60 mmHg (95% CI: -7.18 to -2.03).
FeedsGLP-1 receptor agonists×blood pressure
Systolic blood pressureGLP-1RAs vs placebo, insulin, and sulfonylureasfavours the treatment · hypertension, t2dfeeds one cell of the map
decrease -1.84-3.48 to -0.20
Compared with placebo, insulin, and sulfonylureas, GLP-1RAs decreased systolic blood pressure with range from -1.84 mmHg (95% CI: -3.48 to -0.20) to -4.60 mmHg (95% CI: -7.18 to -2.03).
FeedsGLP-1 receptor agonists×blood pressure
Diastolic blood pressureexenatide-10 μg-twice-daily vs placebofavours the treatment · hypertension, t2dfeeds one cell of the map
Δ -1.08-1.78 to -0.33
Compared with placebo, a reduction in diastolic blood pressure was detected significantly only for exenatide-10 μg-twice-daily (-1.08 mmHg, 95% CI: -1.78 to -0.33).
FeedsGLP-1 receptor agonists×blood pressure

Read, but not usablea number the graph found but could not read as for or against

Heart rateliraglutide (1.8 mg once daily) vs placebodirection of benefit for this outcome is not defined · hypertension, t2dfeeds one cell of the map
Δ 2.350.94 to 3.76
Exenatide (2 mg once weekly), liraglutide 1.2 mg once daily), and liraglutide (1.8 mg once daily) increased heart rate by 3.35 (95% CI: 1.23-5.50), 2.06 (95% CI: 0.43, 3.74), and 2.35 (95% CI: 0.94-3.76) beats/min versus placebo.
FeedsGLP-1 receptor agonists×adverse events & safety
Heart rateliraglutide 1.2 mg once daily vs placebodirection of benefit for this outcome is not defined · hypertension, t2dfeeds one cell of the map
Δ 2.060.43 to 3.74
Exenatide (2 mg once weekly), liraglutide 1.2 mg once daily), and liraglutide (1.8 mg once daily) increased heart rate by 3.35 (95% CI: 1.23-5.50), 2.06 (95% CI: 0.43, 3.74), and 2.35 (95% CI: 0.94-3.76) beats/min versus placebo.
FeedsGLP-1 receptor agonists×adverse events & safety
Heart rateExenatide (2 mg once weekly) vs placebodirection of benefit for this outcome is not defined · hypertension, t2dfeeds one cell of the map
increase 3.351.23 to 5.50
Exenatide (2 mg once weekly), liraglutide 1.2 mg once daily), and liraglutide (1.8 mg once daily) increased heart rate by 3.35 (95% CI: 1.23-5.50), 2.06 (95% CI: 0.43, 3.74), and 2.35 (95% CI: 0.94-3.76) beats/min versus placebo.
FeedsGLP-1 receptor agonists×adverse events & safety

clause the extractor read what became the number

2 · Its place on the map

Where it lands on the map

Rows are treatments, columns are outcomes. The coloured squares are the cells this paper feeds, coloured by the vote it casts there. Click one to jump to what this paper adds to it.

supports the treatmentfavours the comparatorno clear differenceread, but no usable result
3 · What it changes

What it adds to each cell

For every cell the paper feeds: the belief in the claim with and without this paper, and this paper's estimate drawn against every other readable study in the cell. The ringed dot is this paper.

GLP-1 receptor agonists×blood pressure

SupportsOpen on the map →What to test next →

9 readable studies in this cell: 3 favour the treatment, 5 find no difference, 1 favour the comparator.

Belief with this paper
0.50contested · 2 families support, 1 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT00676338820 enrolled · 2008
Δ 0.36-1.02 to 1.73
NCT00781937422 enrolled · 2008
Treatment Contrast -2.72-4.69 to -0.76
NCT02492763176 enrolled · 2015
Δ -1.10-6.20 to 4.10
NCT04019197108 enrolled · 2019
β coefficient -0.05-0.10 to -0.01
NCT0488111060 enrolled · 2021
Δ -0.00-5.80 to 5.80
Effects of the glucagon-like peptide-1 receptor agonist liraglutide on…PMID 28129251 · 2017
Δ 1.80-4.33 to 7.93
The effects of GLP-1 based therapies on postprandial haemodynamics: Tw…PMID 28086201 · 2017
Δ 6.703.60 to 9.90
Effect of liraglutide on ambulatory blood pressure in patients with hy…PMID 30242948 · 2019
Δ -1.42-4.25 to 1.40
Heart rate acceleration with GLP-1 receptor agonists in type 2 diabete…PMID 27777261 · 2017
Δ -12.6

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

GLP-1 receptor agonists×adverse events & safety

No readable resultOpen on the map →What to test next →

40 readable studies in this cell: 45 favour the treatment, 14 find no difference, 2 favour the comparator.

Belief with this paper
0.00contested · 0 families support, 39 contradict · against placebo
Without itNot a counted family in this claim, so removing it changes nothing.
← favours the treatmentfavours the comparator →
0 · no effect
NCT017204463,297 enrolled · 2013
Δ -0.66-0.80 to -0.52
NCT036893742,274 enrolled · 2018
Δ -0.29-0.38 to -0.20
NCT013360231,663 enrolled · 2011
Treatment contrast -0.64-0.75 to -0.53
NCT040178321,441 enrolled · 2019
Δ -0.20-0.30 to -0.10
NCT018365231,398 enrolled · 2013
Δ -0.20-0.32 to -0.07
NCT019301881,231 enrolled · 2013
Δ -1.06-1.21 to -0.91
NCT007344741,202 enrolled · 2008
Δ -0.71-0.87 to -0.55
NCT008389031,049 enrolled · 2009
Δ -0.91-1.16 to -0.65
NCT009606611,036 enrolled · 2009
Δ -0.04-0.18 to 0.11
NCT050350821,018 enrolled · 2021
Δ -0.24-0.44 to -0.04
NCT01064687978 enrolled · 2010
Δ -1.05-1.22 to -0.88
NCT01117350978 enrolled · 2010
Δ 2.54-3.88 to 8.93

This paper's own estimate is on a different scale from the rest of the cell, so it is not drawn here.

4 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

5 · Its place in the literature

Who cites it

141 citing papers in PubMed, 16 syntheses or guidelines pooled it, 294 citations in OpenAlex.

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  9. Glucagon-Like Peptide-1 Receptor Agonists in Type 2 Diabetes Mellitus and Cardiovascular Disease: The Past, Present, and Future.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2022
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81 more citing papers are in PubMed but not listed here.

6 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

7 · Who and what money

Authors and funding

10 authors at 5 institutions in 2 countries.

Feng SunDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of Preventive Medicine, College of Medicine, Shihezi University, Shihezi 832002, China. Electronic address: siyan-zhan@bjmu.edu.cn.
Shanshan WuNational Clinical Research Center of Digestive Diseases, Beijing Friendship Hospital, Capital Medical University, 95 Yong-an Road, Xi-Cheng District, Beijing 100050, China.
Shuxia GuoDepartment of Preventive Medicine, College of Medicine, Shihezi University, Shihezi 832002, China.
Kai YuDepartment of orthopedics, Tianjin Fifth Central Hospital, Tianjing 300450, China.
Zhirong YangDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Shantou-Oxford Clinical Research Unit, Shantou University Medical College, Guangdong 515041, China.
Lishi LiDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing 100191, China; Department of statistics, Graduate School of Arts and Sciences, Columbia University, New York, NY 10027, USA.
Yuan ZhangDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
Xiaochi QuanDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
Linong JiDepartment of Endocrinology and Metabolism, People's Hospital, Peking University, Beijing 100044, China.
Siyan ZhanDepartment of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Centre, 38 Xueyuan Road, Haidian District, Beijing 100191, China.
Peking University · CNShihezi University · CNColumbia University · USPeking University People's Hospital · CNShantou University · CN

Funding

No grant is acknowledged in the PubMed record.

8 · The paper itself

Abstract

The marked sentences are the ones the graph read a number from.

aimsTo evaluate current evidence of glucagon-like peptide-1 receptor agonists (GLP-1RAs) on blood pressure, heart rate, and hypertension in patients with type 2 diabetes.

methodsMedline, Embase, the Cochrane library, and the website www.clinicaltrials.gov were searched on April 5th, 2014. Randomized-controlled trials with available data were included if they compared GLP-1RAs with placebo and traditional antidiabetic drugs in patients with type 2 diabetes with duration ≥ 12 weeks. Weighted mean difference for blood pressure and heart rate, odds ratio (OR) for hypertension were calculated by random-effect model. Network meta-analysis was performed to supplement direct comparisons.

resultsSixty trials with 14 treatments were included. Compared with placebo, insulin, and sulfonylureas, GLP-1RAs decreased systolic blood pressure with range from -1.84 mmHg (95% CI: -3.48 to -0.20) to -4.60 mmHg (95% CI: -7.18 to -2.03). Compared with placebo, a reduction in diastolic blood pressure was detected significantly only for exenatide-10 μg-twice-daily (-1.08 mmHg, 95% CI: -1.78 to -0.33). Exenatide (2 mg once weekly), liraglutide 1.2 mg once daily), and liraglutide (1.8 mg once daily) increased heart rate by 3.35 (95% CI: 1.23-5.50), 2.06 (95% CI: 0.43, 3.74), and 2.35 (95% CI: 0.94-3.76) beats/min versus placebo. This effect was evident compared with active control (range: 2.22-3.62). No significant association between incident hypertension and GLP-1RAs was detected, except for the association between exenatide-10 μg-twice-daily and sulfonylureas (OR, 0.40, 95% CI: 0.16, 0.82).

conclusionsGLP-1RAs were associated with modest reduction on blood pressure, a slight increase in heart rate, yet no significant association with hypertension. Further investigation to explore mechanisms is warranted.

Indexed as

Glucagon-Like Peptide-1 Receptor AgonistsBlood PressureDiabetes Mellitus, Type 2ExenatideGlucagon-Like Peptide 1Heart RateHumansHypertensionHypoglycemic AgentsInsulinLiraglutidePeptidesRandomized Controlled Trials as TopicSulfonylurea CompoundsVenomsExenatideGlucagon-Like Peptide 1Glucagon-Like Peptide-1 Receptor AgonistsHypoglycemic AgentsInsulinLiraglutidePeptidesSulfonylurea CompoundsVenomsBlood pressureGLP-1 receptor agonistsHeart rateHypertensionNetwork meta-analysisType 2 diabetes

Identifiers

PMID26358202
OpenAlexW1910083626

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.