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Cardiovascular diseases are the leading cause of morbidity and mortality in the world. Diabetes increase heart disease related to death by two- to four-fold. SGLT2 inhibitors are new antidiabetic agents. The growing evidence of cardiovascular benefit of SGLT2 inhibitors independent of their effects on glycemic control is especially intriguing. Several clinical trials have shown that sotagliflozin (SGLT1-1/2 inhibitor) decreases body weight and reduces blood pressure in adults with T2D. A phase 3 study designed to evaluate cardiovascular outcomes of sotagliflozin is currently ongoing. Many pre-clinical studies were conducted to investigate the potential mechanisms involved in cardiovascular benefits of SGLT1 or SGLT2 inhibition with or without diabetes. Although multiple mechanisms have been proposed, there are still not enough data to fully support the mechanisms of actions. This review aims to discuss the potential mechanisms involved in cardiovascular benefits of SGLT1 and SGLT2 inhibition in both diabetic and non-diabetic states.

Further insights into cardiovascular outcomes in diabetic and non-diabetic states: inhibition of sodium-glucose co-transports