Quick release Bromocriptine may improve aortic stiffness in young diabetes 1 patients

Bromocriptine quick release (BCQR) improves blood pressure and central and peripheral aortic stiffness and pressure hemodynamics in adolescents with type 1 diabetes (T1D), a placebo-controlled crossover trial has found. The trial results were published in the journal Hypertension.  

Youth with type 1 diabetes (T1D) are known to have vascular dysfunction, which increases their lifetime risk of cardiovascular events. Vascular dysfunction treatment is a top priority in clinical practice. Hence researchers conducted a placebo-controlled, random-order, double-blinded, cross-over trial called the bromocriptine quick-release T1D study (BCQR-T1D), based on the hypothesis that BCQR would boost vascular health in T1D-afflicted youth. 

The cardiovascular and metabolic impact of BCQR was investigated in the T1DBCQR-T1D trial by a multidisciplinary team at the University of Colorado School of Medicine, Aurora. All adolescents in the BCQR-T1D study were randomized 1:1 to phase-1: 4 weeks of BCQR or placebo. After 4 weeks pulse wave velocity, relative area change, and distensibility from phase-contrast magnetic resonance imaging were used to measure blood pressure and central aortic stiffness measurements. Phase 2 was carried out similarly with the alternative treatment following a 4-week washout period.  

Results of the study:

• Thirty-four adolescents with a mean age of 15.9±2.6 years, hemoglobin A1c 8.6±1.1%, body mass index percentile 71.4±26.1, median T1D duration of 5.8 years with T1D were enrolled and had magnetic resonance imaging data available.
• BCQR therapy decreased systolic (∆=−5 mmHg; P<0.001) and diastolic blood pressure (∆=−2 mmHg; P=0.039) when compared with placebo. 
• Ascending aortic pulse wave velocity was reduced and there was an increase in relative area change and distensibility.
• There was a decrease in pulse wave velocity and an increase in distensibility in the thoracoabdominal aorta by BCQR therapy. 

Thus, using BCQR pressure hemodynamics could be altered like improved blood pressure and central and peripheral aortic stiffness in adolescents with T1DM. As an improvement was found in the aortic stiffness using BCQR further larger studies have to be carried out to understand the effects. 

Further reading: Schäfer M, Browne LP, Truong U, et al. Bromocriptine Improves Central Aortic Stiffness in Adolescents With Type 1 Diabetes: Arterial Health Results From the BCQR-T1D Study [published online ahead of print, 2022 Dec 6]. Hypertension. 2022;10.1161/HYPERTENSIONAHA.122.19547. doi:10.1161/HYPERTENSIONAHA.122.19547