Antihypertensive effect of Dapagliflozin in Type II diabetic patients with Hypertension

Abstract

Hypertension (HTN) and type II diabetes mellitus (T2DM) are two main cardiovascular risk factors that coexist frequently. The aim of this study is evaluation the antihypertensive effect of dapagliflozin in hypertensive type 2 diabetic patients (controlled/inadequately uncontrolled), and study its effect on contributing factors in that effectiveness (ex. weight loss and SNS damping). Primary endpoints included the effect of dapagliflozin on hemoglobin A1C (HbA1c) and blood pressure. Secondary endpoints included the effect of drug on weight body, pulse rate and pulse pressure. Patients were randomly selected from the outpatient of the Endocrinology Department at Tishreen University Hospital in Syria, and divided into two groups: dapagliflozin group (n=45) received 5 or 10mg dapagliflozin once daily as an add-on therapy to oral anti-diabetic drugs (OAD)and antihypertensive drugs, and control group (n=38) received OAD and antihypertensive drugs. After 12 weeks follow-up, dapagliflozin-treated versus control-treated showed significant reduction in HbA1C (-0.7% vs -0.3%, p<0.05, mean seated SBP (-9.4 vs -1.2mmHg, p=0.0001) and mean seated DBP(-6 vs-0.3mmHg, p=0.0001). Dapagliflozin also reduced body weight compared with control (-2.6 vs -0.6kg, p=0.0001) andthere was a significant positive correlation between weight loss and BP reduction. The effect on pulse rate was modest and similar between two groups but dapagliflozin have lowered pulse pressure values. There was no significant dose-response with any studied parameter, too. 5mg dapagliflozin once daily improved glycemic control, reduced body weight, SBP more than DBP and thus improved pulse pressure. All that without any significant effect on pulse rate.