Twenty-Four Hour Blood Pressure Response to Empagliflozin and Its Determinants in Normotensive Non-diabetic Subjects.

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License: CC BY 4.0
Serval ID
serval:BIB_6281EA6B3D3F
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Twenty-Four Hour Blood Pressure Response to Empagliflozin and Its Determinants in Normotensive Non-diabetic Subjects.
Journal
Frontiers in cardiovascular medicine
Author(s)
Zanchi A., Pruijm M., Muller M.E., Ghajarzadeh-Wurzner A., Maillard M., Dufour N., Bonny O., Wuerzner G., Burnier M.
ISSN
2297-055X (Print)
ISSN-L
2297-055X
Publication state
Published
Issued date
2022
Peer-reviewed
Oui
Volume
9
Pages
854230
Language
english
Notes
Publication types: Journal Article
Publication Status: epublish
Abstract
Sodium-glucose co-transport 2 inhibitors (SGLT2i) lower blood pressure (BP) in normotensive subjects and in hypertensive and normotensive diabetic and non-diabetic patients. However, the mechanisms of these BP changes are not fully understood. Therefore, we examined the clinical and biochemical determinants of the BP response to empagliflozin based on 24-h ambulatory BP monitoring.
In this post-hoc analysis of a double-blind, randomized, placebo-controlled study examining the renal effects of empagliflozin 10 mg vs. placebo in untreated normotensive non-diabetic subjects, the 1-month changes in 24 h ambulatory BP were analyzed in 39 subjects (13 placebo/26 empagliflozin) in regard to changes in biochemical and hormonal parameters.
At 1 month, empagliflozin 10 mg decreased 24-h systolic (SBP) and diastolic (DBP) BP significantly by -5 ± 7 mmHg (p < 0.001) and -2 ± 6 mmHg (p = 0.03). The effect on SBP and DBP was more pronounced during nighttime (resp. -6 ± 11 mmHg, p = 0.004; -4 ± 7 mmHg, p = 0.007). The main determinants of daytime and nighttime SBP and DBP responses were baseline BP levels (for daytime SBP: coefficient -0.5; adj. R <sup>2</sup> : 0.36; p = 0.0007; for night-time SBP: coefficient -0.6; adj. R <sup>2</sup> : 0.33; p = 0.001). Although empaglifozin induced significant biochemical changes, none correlated with blood pressure changes including urinary sodium, lithium, glucose and urate excretion and free water clearance. Plasma renin activity and plasma aldosterone levels increased significantly at 1 month suggesting plasma volume contraction, while plasma metanephrine and copeptin levels remained the same. Renal resistive indexes did not change with empagliflozin.
SGLT2 inhibition lowers daytime and nighttime ambulatory systolic and diastolic BP in normotensive non-diabetic subjects. Twenty-four jour changes are pronounced and comparable to those described in diabetic or hypertensive subjects. Baseline ambulatory BP was the only identified determinant of systolic and diastolic BP response. This suggests that still other factors than sustained glycosuria or proximal sodium excretion may contribute to the resetting to lower blood pressure levels with SGLT2 inhibition.
[https://www.clinicaltrials.gov], identifier [NCT03093103].
Keywords
ABPM - 24-h ambulatory blood pressure monitoring, SGLT2 (sodium-glucose cotransporter 2) inhibitor, blood pressure, empagliflozin, healthy volunteer, normotension
Pubmed
Web of science
Open Access
Yes
Create date
25/04/2022 12:13
Last modification date
23/11/2022 7:11
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