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

R Chilton, I Tikkanen, CP Cannon… - Diabetes, Obesity …, 2015 - Wiley Online Library
R Chilton, I Tikkanen, CP Cannon, S Crowe, HJ Woerle, UC Broedl, OE Johansen
Diabetes, Obesity and Metabolism, 2015Wiley Online Library
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 …
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.
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