Association of blood pressure and body weight decline during one-year treatment with the incretin analogue exenatide.

Exenatide treatment is related to lower blood pressure. It is explained by different patho physiological pathways. We explored the dynamics of blood pressure and weight loss during one-year therapy with exenatide. Forty-nine type 2 diabetic patients previously treated with a combination of metformin and sulfonylurea were included in this open-label, intention to treat study. Five mg of exenatide was administered twice daily for 4 weeks, and then 10 mg twice daily as adjunctive therapy to the pre-existing treatment. Patients in whom anti hypertensive therapy was modified were excluded from analysis. At the end of 52 weeks, systolic blood pressure decreased significantly, with a 4.65 mm Hg reduction (P=0.008582) in exenatide treated patients. There was a positive correlation between body weight and systolic blood pressure drop (Pearson coefficient 0.675254). The interesting blood pressure curve could have relied on various antihypertensive mechanisms of exenatide: drop of blood pressure at first 16 weeks could have been connected with natriuresis and the second one with later vasodilatation.