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Diabetes Obes Metab. 2015 Dec;17(12):1180-93. doi: 10.1111/dom.12572. Epub 2015 Oct 9.

Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes.

Author information

1
Department of Medicine, University of Texas Health Science Center, San Antonio, TX, USA.
2
Helsinki University Hospital and Minerva Institute for Medical Research, University of Helsinki, Helsinki, Finland.
3
Department of Cardiology, Harvard Clinical Research Institute, Boston, MA, USA.
4
Boehringer Ingelheim Pharma GmbH & Co. KG, Ingelheim, Germany.
5
Boehringer Ingelheim Norway KS, Asker, Norway.

Abstract

AIMS:

To determine the effects of empagliflozin on blood pressure (BP) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus (T2DM).

METHODS:

We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 12 weeks' empagliflozin and four phase III trials in patients with T2DM receiving 24 weeks' empagliflozin (cohort 1, n = 823; cohort 2, n = 2477). BP was measured using 24-h BP monitoring (cohort 1) or seated office measurements (cohort 2).

RESULTS:

Empagliflozin reduced systolic BP (SBP) and diastolic BP in both cohorts (p < 0.001 vs placebo), without increasing heart rate. Empagliflozin reduced pulse pressure (PP; adjusted mean difference vs placebo cohort 1: -2.3 mmHg; cohort 2: -2.3 mmHg), mean arterial pressure (MAP; cohort 1, -2.3 mmHg; cohort 2, -2.1 mmHg) and double product (cohort 1, -385 mmHg × bpm; cohort 2, -369 mmHg × bpm) all p < 0.001 vs placebo. There was a trend towards a reduction in the ambulatory arterial stiffness index (AASI) with empagliflozin in cohort 1 (p = 0.059 vs placebo). AASI was not measured in cohort 2. Subgroup analyses showed that there were greater reductions in PP with increasing baseline SBP in cohort 1 (p = 0.092). In cohort 2, greater reductions in MAP were achieved in patients with higher baseline SBP (p = 0.027) and greater reductions in PP were observed in older patients (p = 0.011).

CONCLUSIONS:

Empagliflozin reduced BP and had favourable effects on markers of arterial stiffness and vascular resistance.

KEYWORDS:

SGLT2 inhibitor; cardiovascular disease; phase III study; type 2 diabetes

PMID:
26343814
PMCID:
PMC5057299
DOI:
10.1111/dom.12572
[Indexed for MEDLINE]
Free PMC Article

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