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Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes
Author(s) -
Chilton R.,
Tikkanen I.,
Can C. P.,
Crowe S.,
Woerle H. J.,
Broedl U. C.,
Johansen O. E.
Publication year - 2015
Publication title -
diabetes, obesity and metabolism
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.445
H-Index - 128
eISSN - 1463-1326
pISSN - 1462-8902
DOI - 10.1111/dom.12572
Subject(s) - empagliflozin , cohort , arterial stiffness , medicine , placebo , cardiology , vascular resistance , blood pressure , type 2 diabetes , mean arterial pressure , surgery , diabetes mellitus , heart rate , endocrinology , pathology , alternative medicine
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.