Empagliflozin lowers blood pressure in T2D

Among hypertensives with type 2 diabetes (T2D), treatment with the sodium-glucose cotransporter 2 (SGLT-2) inhibitor empagliflozin produces clinically meaningful reductions in blood pressure (BP), reports a recent study.

A total of 124 patients were enrolled and randomly assigned to receive 25 mg empagliflozin daily (n=62) or placebo (n=62). The trial was double-blinded and lasted for 12 weeks. All participants were under 24-hour ambulatory BP measurement. Endothelial function and arterial stiffness were likewise assessed at baseline and after 12 weeks.

At follow-up, empagliflozin induced a significantly greater reduction in 24-hour systolic BP from baseline relative to placebo (adjusted mean difference, –8.14 mm Hg, 95 percent confidence interval [CI], –10.32 to –3.96; p=0.005). A similar effect was reported for 24-hour diastolic BP (adjusted mean difference, –5.27 mm Hg, 95 percent CI, –8.19 to –1.35; p<0.001).

Empagliflozin likewise led to significantly greater 12-week decreases in office BP compared with placebo (systolic: adjusted mean difference, –6.27 mm Hg, 95 percent CI, –9.37 to –1.97; p<0.001; diastolic: adjusted mean difference, –4.47 mm Hg, 95 percent CI, –7.41 to –0.47; p<0.001).

Adverse events that occurred at greater frequencies in empagliflozin-treated patients included volume depletion, hypoglycaemic events, and genital infections.

“The merit of our study was that we presented two of possible mechanisms in BP-lowering effect of empagliflozin, which were the improvements of arterial stiffness and endothelial function, making a case for the further studies,” the researchers said.