Antihyperglycemic and Blood Pressure Effects of Empagliflozin in Black Patients With Type 2 Diabetes Mellitus and Hypertension

RCT (n=150) found that emapgliflozin reduced HbA1c, body weight and systolic BP more than placebo (-0.78%, -1.23 kg and -8.39 mmHg, all p<0.05). The difference increased between 12 and 24 weeks suggesting that the full antihypertensive effect takes >6 months to be realised.

A separate study in patients with diabetes and uncontrolled nocturnal hypertension found that empagliflozin significantly reduced nighttime systolic BP vs baseline (-6.3 mmHg, p=0.004) whereas placebo did not.

 

A related editorial discusses these studies. It states that both reports suggest empagliflozin produces reductions in BP of sufficient magnitude to confer reduction in cardiovascular morbidity and mortality and that although SGLT-2 inhibitors are not currently considered first-line agents in the treatment of diabetes mellitus, it may be time to rethink the approach to patients with both diabetes and hypertension. A number of other agents are also being investigated for CVD events in patients with and without diabetes (e.g. canaglifozin and dapaglifozin, sotoglflozin) and results from these trials may challenge conventional recommendations for diabetes management.