Purpose of review The increasing prevalence of hypertension, alongside the growing use of glucagon-like peptide-1 receptor agonists (GLP-1 RAs) for conditions beyond type 2 diabetes, underscores the need for understanding if there is a role for these medications in blood pressure management. This review addresses the timely opportunity to assess how GLP-1 RAs could influence blood pressure control, potentially broadening therapeutic strategies for cardiovascular risk management. Recent findings Emerging literature indicates that GLP-1 RAs influence blood pressure through various mechanisms, such as sympathetic nervous modulation, vasodilation, and diuretic effects. Clinical trials demonstrate modest yet statistically significant reductions in systolic blood pressure (SBP), with less consistent effects on diastolic blood pressure (DBP). The advent of dual GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor agonists presents enhanced possibilities for managing hypertension. Summary The implications of these findings suggest that GLP-1 RAs have potential as adjunctive therapies for hypertension, especially in patients already receiving these agents for other cardiometabolic conditions. The blood pressure-lowering effects, often independent of weight loss or glucose control, warrant further investigation to determine their precise role within hypertension treatment algorithms and encourage integration into clinical practice.
Clinical considerations and pathophysiological associations among obesity, weight loss, heart failure, and hypertension
Purpose of review To describe the relationship between three pandemics: hypertension, obesity, and heart failure. From pathophysiology to treatment, understanding how these disease entities are linked can lead to breakthroughs in their prevention and treatment. The relevance of this review lies in its discussion of novel pharmacological and surgical treatment strategies for obesity and hypertension, and their role in the prevention and treatment of heart failure. Recent findings Novel medications such as GLP-1 agonists have demonstrated sustained weight loss in patients with obesity, and concurrent improvements in their cardiometabolic profile, and possibly also reductions in hypertension-related comorbidities including heart failure. Surgical therapies including laparoscopic bariatric surgery represent an important treatment strategy in obese patients, and recent studies describe their use even in patients with advanced heart failure, including those with ventricular assist devices. Summary These developments have deep implications on our efforts to understand, mitigate, and ultimately prevent the three pandemics, and offer promising improvements to quality of life, survival, and the cost burden of these diseases.
P51: Implications of Significant (>10%) Changes in Body Mass Index in a Contemporary HeartMate 3 Cohort