Primary Care-Based Investigation of the Effect of Sitagliptin on Blood Pressure in Hypertensive Patients With Type 2 Diabetes.
BACKGROUND
The influence of long-term sitagliptin therapy on office blood pressure (BP) and home BP has been unclear.


METHODS
In a retrospective cohort study of 454 patients with type 2 diabetes, the following variables were analyzed before and at 3, 6, 9, and 12 months after initiation of sitagliptin therapy: office systolic blood pressure (SBP), office diastolic blood pressure (DBP), office pulse rate, morning home SBP, morning home DBP, morning home pulse rate, evening home SBP, evening home DBP, evening home pulse rate, hemoglobin A1c (HbA1c), plasma glucose, lipid profile, and renal function parameters.


RESULTS
The office SBP showed a significant decrease after 6 and 12 months of sitagliptin therapy (P < 0.01 and P < 0.01, respectively), while office DBP was decreased significantly at all time points of evaluation (3, 6, 9, and 12 months: P < 0.05, P < 0.001, P < 0.001, and P < 0.05, respectively). Analysis of covariance revealed a significant decrease in office SBP after 6 and 12 months, as well as significant reduction of office DBP after 6 and 9 months. Morning home SBP and DBP were significantly reduced after 6 months, as was evening home DBP after 6 and 12 months, but there was no significant decrease in evening home SBP. HbA1c and plasma glucose levels were significantly reduced at all time points of evaluation. Examination of the lipid profile revealed that total cholesterol, low-density lipoprotein cholesterol, and triglycerides were also decreased at all time points of evaluation, while high-density lipoprotein cholesterol was significantly reduced after 3, 9, and 12 months. Significant reduction of the estimated glomerular filtration rate was observed after 6, 9, and 12 months, and the urinary albumin/creatinine ratio was significantly lower at 9 and 12 months. Serum creatinine was increased significantly at all time points of evaluation.


CONCLUSIONS
BP was slightly but significantly reduced from 6 months after initiation of sitagliptin therapy, indicating that this antidiabetic drug has pleiotropic effects, including an antihypertensive effect.
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Shouhei
S
Yuasa
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Kazuyoshi
K
Sato
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Takamoto
T
Furuki
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Kosuke
K
Minamizawa
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Hiroyuki
H
Sakai
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Yuichi
Y
Numata
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Keiichi
K
Chin
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Jisho
J
Kojima
Hypertension and Renal Disease Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Masaaki
M
Miyakawa
Diabetes Committee Study Group, Kanagawa Physicians Association, Kanagawa, Japan.
Ikuro
I
Matsuba
Diabetes mellitus; Dipeptidyl peptidase-4 inhibitor; Home blood pressure; Hypertension; Pleiotropic effect