Blood Pressure and Cardiovascular Effects of New and Emerging Antidiabetic Agents
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Despite remarkable declines in US cardiovascular disease morbidity and mortality over the last several decades, the prevalence of risk factors such as type 2 diabetes and hypertension remains high, associated with increasing obesity rates. Although optimal glycemic control remains a primary focus to decrease the disease burden, the FDA has issued guidance recommendations for documenting cardiovascular disease-related safety with research trials on new antidiabetic agents with more demanding requirements compared to past approval of existing therapies. This review will discuss the public health impact of type 2 diabetes, specifically with comorbid hypertension; mechanisms of action of the newest antidiabetic drug classes; and preliminary findings and potential clinical significance of the favorable blood pressure and body weight effects of the sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide 1 receptor agonists; and additionally discuss two recent large cardiovascular outcome trials with dipeptidyl peptidase-4 inhibitors.
KeywordsDiabetes Hypertension Antidiabetic drugs Cardiovascular disease Sodium-glucose cotransporter 2 inhibitors Glucagon-like peptide-1 receptor agonists Dipeptidyl peptidase-4 inhibitors Systolic blood pressure Obesity
Compliance with Ethics Guidelines
Conflict of Interest Pelbreton C. Balfour, Jr., declares that he has no conflict of interest.
Carlos J. Rodriguez has received grants from the NIH/NHLBI (R01 HL104199 and R01HL104199-03S1).
Keith C. Ferdinand has received a grant and paid travel expenses from Eli Lilly. He also has received consulting or honoraria payments from Amgen, Sanofi, Boerhinger Ingelheim, Astra Zeneca, Daiichi Sankyo and Novartis. Dr. Ferdinand has also received paid travel expenses from Boerhinger Ingelheim, grants from Daichii Sankyo and lecture payments from Astra Zeneca.
Human and Animal Rights and Informed Consent This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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