Metformin, vildagliptin have differing effects on heart rate, blood pressure in diabetes

These cardiovascular profiles during enteral nutrient exposure may have implications for postprandial hypotension.
These cardiovascular profiles during enteral nutrient exposure may have implications for postprandial hypotension.

(HealthDay News) — Among patients with type 2 diabetes, vildagliptin lowers blood pressure and elevates heart rate, while metformin increases heart rate and has no effect on blood pressure during intraduodenal glucose infusion, according to a study published in Diabetes Care.

Tongzhi Wu, MD, PhD, from the University of Adelaide in Australia, and colleagues examined the effects of vildagliptin and metformin on blood pressure and heart rate responses to intraduodenal glucose in patients with diet-controlled type 2 diabetes. Study A compared vildagliptin and placebo given 60 minutes before a 120-minute intraduodenal glucose infusion (at 2 or 4 kcal/min [intraduodenal 2 and intraduodenal 4]) in 16 patients, while study B compared metformin and placebo given 30 minutes before intraduodenal 2 for 120 minutes in 9 patients.

The researchers found that after vildagliptin versus placebo, systolic and diastolic blood pressure were lower and heart rate was higher; no correlation was observed between vildagliptin and the rate of glucose infusion. Heart rate was increased after metformin versus placebo, with no difference observed in systolic or diastolic blood pressure.

"Vildagliptin reduces blood pressure and increases heart rate, whereas metformin increases heart rate without affecting blood pressure during intraduodenal glucose infusion in type 2 diabetes," the authors wrote. "These distinct cardiovascular profiles during enteral nutrient exposure may have implications for postprandial hypotension."

Study A was supported by Novartis, which supplied the vildagliptin and matching placebo tablets. Study B was funded by Merck Sharp & Dohme, which arranged the supply of metformin and placebo.

Reference

  1. Wu T, Trahair LG, Little TJ, et al. Effects of Vildagliptin and Metformin on blood pressure and heart rate responses to small intestinal glucose in type 2 diabetes. Diabetes Care. 3 March 2017. doi: 10.2337/dc16-2391
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