Blood Pressure Reductions With SGLT2 Inhibitors in Type 2 Diabetes
SGLT2 inhibitor therapy significantly reduced systolic BP.
Sodium-glucose cotransporter 2 (SGLT2) inhibitors produced a beneficial off-target effect on blood pressure (BP) in patients with type 2 diabetes, according to a systematic review and meta-analysis published in the Journal of the American Heart Association.
In the analysis, the researchers examined prospective studies to assess the role of SGLT2 on BP in patients with type 2 diabetes. After searching multiple databases to identify appropriate trial registries, they used random-effects models meta-analysis for quantitative data synthesis.
In all, the meta-analysis included 43 randomized controlled trials and 22,528 patients.
The results suggested that SGLT2 inhibitor therapy significantly reduced systolic BP, with a weighted mean difference of –2.46 mm Hg (95% CI, –2.86 to –2.06). For diastolic BP, the weighted mean difference with treatment was –1.46 mm Hg (95% CI, –1.82 to –1.09).
In addition, the researchers observed the following weighted mean difference effects in patients who received SGLT2 inhibitor therapy: serum triglycerides, –2.08 mg/dL (95% CI, –2.51 to –1.64); total cholesterol, 0.77 mg/dL (95% CI, 0.33-1.21); and body weight, –1.88 kg (95% CI, –2.11 to –1.66).
These findings were robust in sensitivity analyses.
“Treatment with SGLT2 glucose cotransporter inhibitors therefore has beneficial off-target effects on BP in patients with type 2 diabetes mellitus and may also be of value in improving other cardiometabolic parameters, including lipid profile and body weight, in addition to their expected effects on glycemic control,” the researchers concluded. “However, our findings should be interpreted with consideration for the moderate statistical heterogeneity across the included studies.”
Other study limitations of note, according to the researchers, included the relatively small sample size of most of the featured studies, the lack of uniformity in participants' background therapies, and the short follow-up periods.
Mazidi M, Rezaie P, Gao HK, Kengne AP. Effect of sodium-glucose cotransport-2 inhibitors on blood pressure in people with type 2 diabetes mellitus: A systematic review and meta-analysis of 43 randomized cohort trials with 22 528 patients. J Am Heart Assoc. 2017;6:e004007. doi:10.1161/JAHA.116.004007