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The anti-hypertensive effects of sodium-glucose cotransporter-2 inhibitors

Luxcia Kugathasan1,2,3, Lisa Dubrofsky4,5,6, Andrew Advani7,8

  • 1Department of Medicine, Division of Nephrology, University Health Network, Toronto, Ontario, Canada.

Expert Review of Cardiovascular Therapy
|December 16, 2022
PubMed

Insights

Sodium-glucose cotransporter-2 (SGLT2) inhibitors offer modest blood pressure reduction, particularly in high-risk patients. These agents may serve as an effective add-on therapy for hypertension management in cardiovascular and kidney disease.

Area of Science:

  • Cardiology
  • Nephrology
  • Pharmacology

Background:

  • Hypertension is a significant risk factor for cardiovascular events in patients with chronic kidney disease, heart failure, obesity, and diabetes.
  • Many patients do not achieve target blood pressure (BP) levels despite standard antihypertensive treatments.

Approach:

  • This review analyzes clinical BP-lowering data from major cardiovascular and kidney outcome trials involving sodium-glucose cotransporter-2 (SGLT2) inhibitors.
  • It also includes data from smaller trials focused on BP reduction in high-risk individuals, with or without diabetes.

Key Points:

  • SGLT2 inhibitors demonstrate generally modest BP-lowering effects, with potentially greater impact in specific patient groups.
  • Potential mechanisms include natriuresis, hemodynamic shifts, a loop diuretic-like action, and vascular physiology alterations.

Conclusions:

  • SGLT2 inhibitors can play an adjunctive role in BP management for hypertensive patients at high risk of cardiovascular or kidney disease.
Abstract

Keywords:
SGLT2 inhibitorschronic kidney diseasediabetesheart failurehypertension

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