GLP-1 receptor agonists and vascular protection

Am J Physiol Heart Circ Physiol. 2024 Mar 1. doi: 10.1152/ajpheart.00574.2023. Online ahead of print.ABSTRACTAtherosclerotic cardiovascular disease is a chronic condition that often co-presents with type 2 diabetes and obesity. Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are incretin mimetics endorsed by major professional societies for improving glycemic status and reducing atherosclerotic risk in people living with type 2 diabetes. While the cardioprotective efficacy of GLP-1RAs and their relationship with traditional risk factors are well-established, there is a paucity of publications that have summarized the potentially direct mechanisms through which GLP-1RAs mitigate atherosclerosis. This review aims to narrow this gap by providing comprehensive and in-depth mechanistic insight to the anti-atherosclerotic properties of GLP-1RAs demonstrated across large outcome trials. Herein, we describe the landmark cardiovascular outcome trials that triggered widespread excitement around GLP-1RAs as a modern class of cardioprotective agents, followed by a summary of the origins of GLP-1RAs and their mechanisms of action. The effects of GLP-1RAs at each major pathophysiological milestone of atherosclerosis, as observed across clinical trials, animal models, and cell culture studies, are described in detail. Specifically, this review provides recent pre-clinical and clinical evidence that suggest GLP-1RAs preserve vessel health in part by preventing endothelial dysfunction, a...
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Source Type: research