Effects of exenatide and liraglutide on heart rate, blood pressure and body weight: systematic review and meta-analysis.
OBJECTIVE
To synthesise current evidence for the effects of exenatide and liraglutide on heart rate, blood pressure and body weight.


METHODS
Meta-analysis of available data from randomised controlled trials comparing Glucagon-like peptide-1 (GLP-1) analogues with placebo, active antidiabetic drug therapy or lifestyle intervention.


METHODS
Patients with type 2 diabetes.


METHODS
Weighted mean differences between trial arms for changes in heart rate, blood pressure and body weight, after a minimum of 12-week follow-up.


RESULTS
32 trials were included. Overall, GLP-1 agonists increased the heart rate by 1.86 beats/min (bpm) (95% CI 0.85 to 2.87) versus placebo and 1.90 bpm (1.30 to 2.50) versus active control. This effect was more evident for liraglutide and exenatide long-acting release than for exenatide twice daily. GLP-1 agonists decreased systolic blood pressure by -1.79 mm Hg (-2.94 to -0.64) and -2.39 mm Hg (-3.35 to -1.42) compared to placebo and active control, respectively. Reduction in diastolic blood pressure failed to reach statistical significance (-0.54 mm Hg (-1.15 to 0.07) vs placebo and -0.50 mm Hg (-1.24 to 0.24) vs active control). Body weight decreased by -3.31 kg (-4.05 to -2.57) compared to active control, but by only -1.22 kg (-1.51 to -0.93) compared to placebo.


CONCLUSIONS
GLP-1 analogues are associated with a small increase in heart rate and modest reductions in body weight and blood pressure. Mechanisms underlying the rise in heart rate require further investigation.
Warwick Medical School, University of Warwick, Coventry,  UK.
Louise E
LE
Robinson
Tim A
TA
Holt
Karen
K
Rees
Harpal S
HS
Randeva
Joseph P
JP
O'Hare