Blood pressure changes during smoking cessation on dulaglutide and placebo treatment - a secondary analysis of the randomized, double-blind, placebo-controlled SKIP trial

Beck Julia; Flavia Hasenbohler; Sophia Lengsfeld; Thilo Burkard; Andrea Meienberg; Nica Jeanloz; Tanja Vukajlovic; Katja Bologna; Cemile Bathelt; Deborah Vogt; Laura Werlen; Mirjam Christ-Crain; Bettina Winzeler

doi:10.1530/endoabs.99.P31

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Endocrine Abstracts (2024) 99 P31 | DOI: 10.1530/endoabs.99.P31

ECE2024 Poster Presentations Adrenal and Cardiovascular Endocrinology (95 abstracts)

Blood pressure changes during smoking cessation on dulaglutide and placebo treatment – a secondary analysis of the randomized, double-blind, placebo-controlled SKIP trial

Beck Julia , Flavia Hasenböhler , Sophia Lengsfeld , Thilo Burkard , Andrea Meienberg , Nica Jeanloz , Tanja Vukajlovic , Katja Bologna , Cemile Bathelt , Deborah Vogt , Laura Werlen , Mirjam Christ-Crain & Bettina Winzeler

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Universitätsspital Basel, Basel, Switzerland

Objective: Smoking is an established major risk for atherosclerosis and cardiovascular mortality. However, the impact of smoking cessation on blood pressure remains controversial. Despite strong evidence linking smoking cessation to reduced cardiovascular risk, conflicting studies suggest potential increases in blood pressure after smoking cessation. Post cessational weight gain may contribute to these confliciting findings. We have recently shown that the glucagon-like peptide-1 (GLP-1) analog dulalgutide counteracts post-cessational weight gain. Therefore, the aim of this secondary analysis was to investigate blood pressure changes during smoking cessation in dulaglutide versus placebo treated individuals.

Design and methods: This is a predefined secondary analysis of the SKIP trial, a randomized, double-blind, placebo-controlled trial, conducted at the University Hospital Basel in Switzerland. Participants (n=218) underwent a 12-week smoking cessation program including standard of care and weekly injections of dulaglutide 1.5 mg or placebo. A mediation path analysis was performed to quantify the effect of predefined variables and relationships.

Results: In the short term (12 weeks), smoking cessation led to a weight gain of +0.96 kg [CI 0.23, 1.70, P-value =0.01], with each kilogram increase associated with a systolic blood pressure rise of +0.55 mmHg [−0.0, 1.11, P-value =0.055]. Dulaglutide treatment resulted in a weight reduction of −3.02 kg [CI −3.69, −2.63, P-value =0.001], and each kilogram decrease lowered systolic blood pressure by −1.66 mmHg [−3.40, 0.08, P-value =0.06]. No direct effect on systolic blood pressure was observed for smoking cessation or dulaglutide without weight influence. In the long term (52 weeks), smoking cessation led to a significant weight increase of +4.20 kg [2.67, 5.74, P-value <0.001]. No direct effect of smoking cessation on systolic blood pressure was observed, either independently or through weight change.

Conclusion: Our findings indicate that blood pressure changes during smoking cessation are primarily mediated by weight change. This underlines the importance of weight control and a potential beneficial role of GLP-1 analogues in the context of smoking cessation.