Sodium-glucose cotransporter-2 inhibitors significantly reduced systolic blood pressure by 1.68 mmHg compared to controls in patients with heart failure.
Meta-Analysis (n=16,181)
Does SGLT2i reduce blood pressure in patients with heart failure?
SGLT2 inhibitors significantly reduce systolic blood pressure, body weight, and HbA1c in patients with heart failure, providing additional mechanistic insights into their cardioprotective effects.
Mean Difference: -1.68 (95% CI -2.7–-0.66)
p-value: p=0.001
Abstract Background Recent studies have shown that sodium-glucose cotransporter-2 inhibitors (SGLT2i) can achieve significant improvement in blood pressure in people with diabetes. Furthermore, randomized controlled trials (RCTs) have established that SGLT2i have a cardioprotective effect in adults with heart failure (HF). Therefore, we performed this systematic review an meta-analysis to determine the effect of SGLT2i on blood pressure in patients with HF. Methods We used the Medline, Cochrane Library, Embase, and PubMed databases to identify RCTs (published through to April 29, 2022) that evaluated the effect of SGLT2i on HF. The primary endpoint was defined as change in blood pressure. Secondary composite outcomes were heart rate, hematocrit, body weight, and glycated hemoglobin. The N-terminal pro-brain natriuretic peptide level, Kansas City Cardiomyopathy Questionnaire scores, and estimated glomerular filtration rate were also evaluated. Results After a literature search and detailed evaluation, 16 RCTs were included in the quantitative analysis. Pooled analyses showed that SGLT2i were associated with a statistically significant reduction in systolic blood pressure of 1.68 mmHg (95% confidence interval CI − 2.7, − 0.66; P = 0.001; I 2 = 45%) but not diastolic blood pressure (mean difference MD −1.06 mmHg; 95% CI −3.20, 1.08; P = 0.33; I 2 = 43%) in comparison with controls. Furthermore, SGLT2i decreased body weight (MD − 1.36 kg, 95% CI − 1.68, − 1.03; P < 0.001; I 2 = 61%) and the glycated hemoglobin level (MD − 0.16%, 95% CI − 0.28, −0.04, P = 0.007; I 2 = 91%) but increased hematocrit (MD 1.63%, 95% CI 0.63, 2.62, P = 0.001; I 2 = 100%). There was no significant between-group difference in heart rate (MD − 0.35; 95% CI − 2.05, 1.35, P = 0.69; I 2 = 0). Conclusions SGLT2i decreased systolic blood pressure in patients with HF but had no effect on diastolic blood pressure. These inhibitors may have numerous potentially beneficial clinical effects in patients with HF.
Li et al. (Mon,) conducted a meta-analysis in Heart failure (n=16,181). Sodium-glucose cotransporter-2 inhibitors (SGLT2i) vs. Placebo or active control was evaluated on Change in systolic blood pressure (MD -1.68, 95% CI -2.7 to -0.66, p=0.001). Sodium-glucose cotransporter-2 inhibitors significantly reduced systolic blood pressure by 1.68 mmHg compared to controls in patients with heart failure.