| Aim:To systematically evaluate the effect of glucagon-like peptide-1 receptor agonists(GLP-1 RA)on blood pressure in patients with type 2 diabetes mellitus(T2DM).Methods:We searched multiple database including PubMed,Embase,Cochrane Library,Web of science from establishment of the database to December 2019 to collect the effects of GLP-1 RA on T2DM blood pressure level in RCT.According to the inclusion and exclusion criteria of the study,relevant literatures were screened out,and data were extracted.The quality was evaluated according to the Cochrane Handbook,using RevMan 5.3 software into the research for statistical analysis.The mean difference(MD)was used as the effect amount to test the heterogeneity of the included studies.A fixed effect model was selected Meta-analysis was performed,sensitivity analysis was used to evaluate the stability of the research results,and funnel charts were used to assess publication bias.Results:Eighteen placebo-controlled RCT studies were included.Four of the studies were based on the exendin-4 structure and 14 were based on the GLP1structure,and 3884 subjects in total.Using a fixed effects model,meta analysis results suggest that:(1)Comparing with the control group,the GLP-1 RA group can reduce systolic blood pressure[MD=-3.08,95%CI(-3.60,-2.30),P<0.00001,I ~2=27%],and the difference is statistically significant.However,about diastolic blood pressure,the GLP-1 receptor agonist group was not statistically different from the control group[MD=-0.41,95%CI(-0.83,0.01),P=0.05,I ~2=22%].(2)In improving systolic and diastolic blood pressure,drugs with low amino acid sequence homology to human GLP-1 may be superior to those with high homology.(3)In improving blood pressure,short-acting preparations may be better than long-acting preparations.Conclusion:The effect of using GLP-1 receptor agonists on blood pressure in patients with type 2 diabetes is mainly as follows:reducing systolic blood pressure.However,due to the small number of included studies,different treatment cycles,and different types of GLP-1 RA,the conclusion of the effect of different types of drugs on blood pressure needs to be further verified by a large sample,high-quality RCT. |
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