[Glucagon like peptide-1 and the cardiovascular system: pathophysiological mechanisms]

The glucagon-like peptide-1 (GLP-1) is an incretin hormone of 31 amino acids synthesized by L cells of ileum and colon in response to the meal. Once secreted, it is rapidly inactivated by enzymes called dipeptidyl dipeptidase 4. The main actions are: 1) the stimulation of insulin secretion; 2) the inhibition of glucagon secretion; 3) the delay of the gastric emptying time; 4) the stimulation of neogenesis of insulin-secreting cells. Patients with type 2 diabetes have a low concentration of GLP-1 in response to the meal and for this reason treatment with incretin mimetic drugs is specifically indicated in these patients. In addition to these important effects on intermediary metabolism, GLP-1 has important actions at the level of other organ systems, such as the cardiovascular system. GLP-1 receptor agonists are able to reduce blood pressure, improve endothelial function, increase myocardial contractility. These effects will be discussed in detail in this article.