GLP-1 receptor agonists and pulmonary hypertension in diabetes: A promising therapeutic strategy

IF 1.8 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS

American heart journal plus : cardiology research and practice Pub Date : 2025-05-28 DOI:10.1016/j.ahjo.2025.100555

Arif Albulushi , Khaled El-Sharnouby , Kareem Soror , Noora Alhajri , Giuseppe Imperator

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Abstract

Background

Pulmonary hypertension (PH) is an emerging and underrecognized complication of diabetes mellitus, linked to adverse cardiopulmonary outcomes. Insulin resistance, inflammation, and endothelial dysfunction contribute to PH pathogenesis.

Objective

This review evaluates the emerging role of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in mitigating PH risk among diabetic patients.

Methods

We synthesized data from preclinical and clinical studies, including large-scale observational cohorts, investigating GLP-1RAs' effects on pulmonary vasculature and hemodynamics.

Results

GLP-1RAs exhibit anti-inflammatory, vasodilatory, and endothelial-protective properties, with associated improvements in pulmonary artery pressure, vascular remodeling, and cardiopulmonary load. A Veterans Affairs cohort and meta-analyses suggest a reduced PH incidence among GLP-1RA users.

Conclusion

GLP-1RAs may represent a novel cardiopulmonary intervention in diabetes care. Prospective trials are needed to confirm their protective role against PH and define optimal integration into therapeutic strategies.

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GLP-1受体激动剂和糖尿病肺动脉高压：一个有前途的治疗策略

背景：肺动脉高压（PH）是糖尿病的一种新出现且未被充分认识的并发症，与不良心肺预后有关。胰岛素抵抗、炎症和内皮功能障碍参与PH的发病机制。目的评价胰高血糖素样肽-1受体激动剂（GLP-1RAs）在降低糖尿病患者PH风险中的新作用。方法综合临床前和临床研究数据，包括大规模观察队列，研究GLP-1RAs对肺血管和血流动力学的影响。结果glp - 1ras具有抗炎、血管扩张和内皮保护特性，并能改善肺动脉压、血管重构和心肺负荷。一项退伍军人事务队列和荟萃分析表明，GLP-1RA使用者的PH发病率降低。结论lp - 1ras可能是糖尿病护理中一种新的心肺干预手段。需要前瞻性试验来确认它们对PH的保护作用，并确定治疗策略的最佳整合。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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