Impact of Empagliflozin on Blood Pressure in Patients with Type 2 Diabetes Mellitus and Hypertension by Background Antihypertensive Medication

Giuseppe Mancia, Christopher P. Cannon, Ilkka Tikkanen, Cordula Zeller, Ludwin Ley, Hans J. Woerle, Uli C. Broedl, Odd Erik Johansen

Research output: Contribution to journalArticle

Abstract

In the EMPA-REG BP trial, empagliflozin 10 mg and 25 mg once daily reduced glycohemoglobin, blood pressure (BP), and weight versus placebo in patients with type 2 diabetes mellitus and hypertension. Patients received placebo (n=271), empagliflozin 10 mg (n=276), or empagliflozin 25 mg (n=276) for 12 weeks (n=full analysis set). This present analysis investigated changes from baseline to week 12 in mean 24-hour systolic BP (SBP) and diastolic BP (DBP) in patients receiving 0, 1, or ≥2 antihypertensive medications and patients receiving/not receiving diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Compared with placebo, empagliflozin 10 mg and 25 mg reduced mean 24-hour SBP/DBP in patients receiving 0 (10 mg: -3.89/-2.58 mm Hg; 25 mg: -3.77/-2.45 mm Hg), 1 (10 mg: -4.74/-1.97 mm Hg; 25 mg: -4.27/-1.81 mm Hg), or ≥2 (10 mg: -2.36/-0.68 mm Hg; 25 mg: -4.17/-1.54 mm Hg) antihypertensives. The effect of empagliflozin was not significantly different between subgroups by number of antihypertensives for changes in SBP (interaction P value 0.448) or DBP (interaction P value 0.498). Empagliflozin reduced 24-hour mean SBP/DBP irrespective of diuretic or angiotensin-converting enzyme inhibitor/angiotensin receptor blocker use, with no significant difference between subgroups by use/no use of diuretics (interaction P values 0.380 [systolic]; 0.240 [diastolic]) or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (interaction P values 0.900 [systolic]; 0.359 [diastolic]). In conclusion, in patients with type 2 diabetes mellitus and hypertension, empagliflozin for 12 weeks reduced SBP and DBP versus placebo, irrespective of the number of antihypertensives and use of diuretics or angiotensin-converting enzyme inhibitors/angiotensin receptor blockers. Clinical Trial Registration - URL: https://clinicaltrials.gov. Unique identifier: NCT01370005.

Original languageEnglish
Pages (from-to)1355-1364
Number of pages10
JournalHypertension
Volume68
Issue number6
DOIs
Publication statusPublished - Dec 1 2016

Keywords

  • antihypertensive
  • blood pressure
  • diuretic
  • empagliflozin
  • hypertension
  • SGLT2 inhibitor
  • type 2 diabetes mellitus

ASJC Scopus subject areas

  • Internal Medicine

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  • Cite this

    Mancia, G., Cannon, C. P., Tikkanen, I., Zeller, C., Ley, L., Woerle, H. J., Broedl, U. C., & Johansen, O. E. (2016). Impact of Empagliflozin on Blood Pressure in Patients with Type 2 Diabetes Mellitus and Hypertension by Background Antihypertensive Medication. Hypertension, 68(6), 1355-1364. https://doi.org/10.1161/HYPERTENSIONAHA.116.07703