At the same time, when GLP-1 is used in conjunction with other antihypertensive agents, its antihypertensive effect appears to be adjunctive and independent of the effects of other antihypertensive agents (115)
Triggers documented in trials and community reports: Normal-sized portions during weeks 1-4 High-fat or high-fiber meals Large liquid volumes with meals Dose increases without gradual escalation Community-reported management strategies: Community sources describe eating slowly and stopping when satisfied Avoidance of liquids with meals is commonly described Bland, easy-to-digest foods early in the course Dose reduction reported when vomiting persisted Constipation Frequency: 9% of trial participants Onset: 1-2 weeks into treatment Duration: Can persist throughout treatment Severity: Usually mild, manageable Constipation results from slowed GI motility - a direct effect of GLP-1 receptor activation
Mainstay treatments are renin-angiotensin-aldosterone system inhibitors, mineralocorticosteroid antagonists and -blockers, and, as mentioned earlier, SGLT-2 inhibitors, especially in people with comorbid diabetes
It takes at least four months to reach the maximum dose of 2 mg, although some people continue to take a smaller dose, such as 1 mg weekly
![Cardiovascular disease continuum-GLP-1 action. Adapted from [46]](https://www.researchgate.net/publication/357072789/figure/fig1/AS:1146405179654167@1650335702879/Cardiovascular-disease-continuum-GLP-1-action-Adapted-from-46.png)
