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Effect of sodium-glucose co-transporter inhibitors on blood pressure values. A new class of diuretic drugs?
Affiliations- Calisia University, Kalisz, Poland
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
open access
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.
Keywords
SGLT2 inhibitors; blood pressure; blood vessel stiffness; activity of the sympathetic nervous system; endothelium
About this articleTitle
Effect of sodium-glucose co-transporter inhibitors on blood pressure values. A new class of diuretic drugs?
Journal
Issue
Article type
Review paper
Pages
60-66
Published online
2022-05-30
Page views
4325
Article views/downloads
717
DOI
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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