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LEADER-4: blood pressure control in patients with type 2 diabetes and high cardiovascular risk: baseline data from

John R Petrie1, Steven P Marso, Stephen C Bain

  • 1aInstitute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK bDivision of Cardiology, Department of Internal Medicine, University of Texas Southwestern, Dallas, Texas, USA cInstitute of Life Science, College of Medicine, Swansea University Medical School, Swansea, UK dMossakowski Medical Research Centre, Polish Academy of Sciences eDepartment of Internal Diseases, Endocrinology and Diabetology, Central Clinical Hospital MSW, Warsaw, Poland fKardio Metabolischen Instituts, Villingen-Schwenningen, Germany gEndocrinology and Nutrition Department, Hospital Son Llàtzer, University Institute of Health Science Research (IUNICS)-Universitat de les Illes Balears, Palma de Mallorca, Spain hDivisions of Endocrinology & Metabolism, Li Ka Shing Knowledge Institute and Keenan Research Centre for Biomedical Science, St. Michael's Hospital, University of Toronto, Ontario, Canada i1st Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic jDivision of Endocrinology and Metabolism, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey kDepartment of Diabetes and Endocrinology, Nelson R Mandela School of Medicine, University of KwaZulu Natal, South Africa lEndocrinology Research Centre, Diabetes Institute mI.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation nFaculty of Medicine, Antwerp University Hospital, Antwerp, Belgium oDepartment of Nephrology, Hypertension & Rheumatology, Friedrich Alexander University of Erlangen, Munchen, Germany pNovo Nordisk, A/S, Bagsvaerd, Denmark qLunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, University of Toronto, Toronto, Canada rInternational Centre for Circulatory Health, Imperial College London, London, UK.

Journal of Hypertension
|February 9, 2016
PubMed

Insights

Blood pressure control is insufficient in most people with type 2 diabetes mellitus (T2DM) and high cardiovascular risk. Glucagon-like peptide-1 receptor agonists may improve blood pressure, but baseline control remains a challenge.

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are known to lower blood pressure (BP).
  • Type 2 diabetes mellitus (T2DM) is associated with increased cardiovascular disease (CVD) risk.
  • Effective BP management is crucial for mitigating CVD risk in T2DM patients.

Purpose of the Study:

  • To assess BP control in relation to international targets before randomization in the LEADER trial.
  • To analyze baseline BP control in high-risk T2DM patients enrolled in the LEADER trial.

Main Methods:

  • Analysis of baseline data from the LEADER trial (NCT01179048), a phase 3B cardiovascular outcomes trial.
  • Inclusion of 9340 participants with T2DM from 32 countries, all at high risk for CVD.
  • Evaluation of BP control against targets of <140/85 mmHg and <130/80 mmHg.

Main Results:

  • Only 51% of participants achieved a BP target of <140/85 mmHg, and only 26% reached <130/80 mmHg.
  • Participants with prior CVD received more antihypertensive agents but had lower BP than those without.
  • Residency in North America was the strongest predictor of achieving BP control targets.

Conclusions:

  • BP remains inadequately controlled in a significant proportion of high-risk T2DM individuals, especially outside North America.
  • These findings highlight the need for improved BP management strategies in T2DM patients.
  • Further analysis of LEADER trial data may elucidate the role of GLP-1 RAs in BP control and CVD outcomes.
Abstract

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