Improvements in Blood Pressure (BP) and Markers of Arterial Stiffness with Canagliflozin (CANA) in the CANagliflozin CardioVascular Assessment Study (CANVAS) Program

Abstract

The CANVAS Program demonstrated a reduced risk of cardiovascular (CV) and renal outcomes with the SGLT2 inhibitor CANA vs. placebo (PBO) in adults with T2DM and established CV disease or ≥2 CV risk factors (N = 10,142; mean age, 63.3 y; systolic BP [SBP], 136.6 mmHg; diastolic BP [DBP], 77.7 mmHg). This analysis assessed the effects of CANA on BP, pulse, and markers of arterial stiffness including pulse pressure (PP = SBP-DBP) and double product (DP = pulse × SBP). CANA lowered SBP and DBP compared with PBO over the CANVAS Program (mean differences of -3.93 mmHg [95% CI: -4.30, -3.56]) and -1.39 mmHg [95% CI: -1.61, -1.17]; both P <0.001). There were no meaningful differences in pulse over 104 weeks; a ∼0.5 bpm reduction in pulse was seen with CANA at Week 26, which remained stable over time, while pulse with PBO was similar to baseline over 104 weeks. CANA provided reductions in PP and DP compared with PBO (Figure). There was an initial reduction in PP that increased over time with CANA, but remained lower compared with PBO. CANA also provided an initial reduction in DP that was sustained over time. Thus we observed favorable effects of CANA on BP, pulse, and markers of arterial stiffness in patients with T2DM with CV risk factors or established CV disease, which may contribute to the beneficial effects of CANA on CV outcomes. Disclosure R. Townsend: None. M. Dharmalingam: None. S. Genovese: Speaker's Bureau; Self; Abbott Diabetes Care, AstraZeneca, Boehringer Ingelheim, Bruno Farmaceutici, Bristol-Myers Squibb, Eli Lilly, Janssen, Lifescan, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi, Takeda. Consultant; Self; Abbott Diabetes Care, AstraZeneca, Boehringer Ingelheim, Bruno Farmaceutici, Bristol-Myers Squibb, Eli Lilly, Janssen, Lifescan, Merck Sharp & Dohme, Novartis, Novo Nordisk, Sanofi, Takeda. Research Support; Self; Novartis AG. A. Steele: Speaker's Bureau; Self; Amgen, AZ, Bayer, BI, Lilly, Jansen, Merck, Pfizer, Otsuka, Valeant. Advisory Panel; Self; Amgen, BI/Lilly, Jansen, Otsuka, Shire. J.L. Arenas: None. A. Slee: Other Relationship; Self; Janssen Scientific Affairs, LLC. E. Fabbrini: Employee; Self; Janssen Research & Development. K.W. Mahaffey: Research Support; Self; Afferent, Amgen, AstraZeneca, Daiichi, Ferring, Google (Verily), Janssen, Medtronic, Merck, Novartis, Sanofi, and St. Jude. Consultant; Self; Ablynx, AstraZeneca, BAROnova, Bio2 Medical, Boehringer Ingelheim, Bristol-Myers Squibb, Cardiometabolic Health Congress, Cubist, Eli Lilly, Elsevier, Epson, GlaxoSmithKline, Janssen, Merck, Mt. Sinai, Radiometer, Springer Publishing, The Medicines Company, Theravance, Vindico, and WebMD. Stock/Shareholder; Self; BioPrint Fitness.