open access

Vol 26, No 2 (2022)
Review paper
Published online: 2022-05-30
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Effect of sodium-glucose co-transporter inhibitors on blood pressure values. A new class of diuretic drugs?

Jerzy Głuszek1, Teresa Kosicka2
DOI: 10.5603/AH.a2022.0010
·
Arterial Hypertension 2022;26(2):60-66.
Affiliations
  1. Calisia University, Kalisz, Poland
  2. Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland

open access

Vol 26, No 2 (2022)
REVIEW
Published online: 2022-05-30

Abstract

New sodium-glucose co-transporter (SGLT 2) inhibitors are already widely used in patients with diabetes mellitus and in patients with heart failure. From the beginning of their use, it has been noticed that they slightly but statistically significantly lower both systolic blood pressure (SBP) and diastolic blood pressure (DBP). The antidiabetic activity of these drugs is based on the inhibition of the reabsorption of glucose and partially sodium in the renal tubules, which leads to an increase in the amount of urine excreted.

Most likely, increased diuresis is responsible for the drop in blood pressure (BP). So far, numerous meta-analyses confirming the reduction of BP in diabetic patients have already been published, for both office BP and home BP, twenty-four hour BP and ambulatory central blood pressure. The action of SGLT 2 inhibitors, after a single administration, extends over 24 hours and there are already the first successful attempts to use them in hypertension in the course of diabetes mellitus with obstructive sleep apnea.

The action of SGLT 2 inhibitors is pleiotropic and, apart from the diuretic effect, they slightly reduce the patient’s weight, reduce the activity of the sympathetic nervous system, restore the normal function of the endothelium, increase uric acid excretion, and reduce blood vessel stiffness. All these factors are responsible for the drop in BP.

These favorable properties of SGLT 2 inhibitors indicate that these drugs will be increasingly used, probably not only in diabetes.

Abstract

New sodium-glucose co-transporter (SGLT 2) inhibitors are already widely used in patients with diabetes mellitus and in patients with heart failure. From the beginning of their use, it has been noticed that they slightly but statistically significantly lower both systolic blood pressure (SBP) and diastolic blood pressure (DBP). The antidiabetic activity of these drugs is based on the inhibition of the reabsorption of glucose and partially sodium in the renal tubules, which leads to an increase in the amount of urine excreted.

Most likely, increased diuresis is responsible for the drop in blood pressure (BP). So far, numerous meta-analyses confirming the reduction of BP in diabetic patients have already been published, for both office BP and home BP, twenty-four hour BP and ambulatory central blood pressure. The action of SGLT 2 inhibitors, after a single administration, extends over 24 hours and there are already the first successful attempts to use them in hypertension in the course of diabetes mellitus with obstructive sleep apnea.

The action of SGLT 2 inhibitors is pleiotropic and, apart from the diuretic effect, they slightly reduce the patient’s weight, reduce the activity of the sympathetic nervous system, restore the normal function of the endothelium, increase uric acid excretion, and reduce blood vessel stiffness. All these factors are responsible for the drop in BP.

These favorable properties of SGLT 2 inhibitors indicate that these drugs will be increasingly used, probably not only in diabetes.

Get Citation

Keywords

SGLT2 inhibitors; blood pressure; blood vessel stiffness; activity of the sympathetic nervous system; endothelium

About this article
Title

Effect of sodium-glucose co-transporter inhibitors on blood pressure values. A new class of diuretic drugs?

Journal

Arterial Hypertension

Issue

Vol 26, No 2 (2022)

Article type

Review paper

Pages

60-66

Published online

2022-05-30

Page views

1391

Article views/downloads

283

DOI

10.5603/AH.a2022.0010

Bibliographic record

Arterial Hypertension 2022;26(2):60-66.

Keywords

SGLT2 inhibitors
blood pressure
blood vessel stiffness
activity of the sympathetic nervous system
endothelium

Authors

Jerzy Głuszek
Teresa Kosicka

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