Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes
Aims To determine the effects of empagliflozin on blood pressure (BP) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus (T2DM). Methods We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 1...
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| Veröffentlicht in: | Diabetes, obesity & metabolism obesity & metabolism, 2015-12, Vol.17 (12), p.1180-1193 |
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| creator | Chilton, R. Tikkanen, I. Cannon, C. P. Crowe, S. Woerle, H. J. Broedl, U. C. Johansen, O. E. |
| description | Aims
To determine the effects of empagliflozin on blood pressure (BP) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus (T2DM).
Methods
We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 12 weeks' empagliflozin and four phase III trials in patients with T2DM receiving 24 weeks' empagliflozin (cohort 1, n = 823; cohort 2, n = 2477). BP was measured using 24‐h BP monitoring (cohort 1) or seated office measurements (cohort 2).
Results
Empagliflozin reduced systolic BP (SBP) and diastolic BP in both cohorts (p |
| doi_str_mv | 10.1111/dom.12572 |
| format | Article |
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To determine the effects of empagliflozin on blood pressure (BP) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus (T2DM).
Methods
We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 12 weeks' empagliflozin and four phase III trials in patients with T2DM receiving 24 weeks' empagliflozin (cohort 1, n = 823; cohort 2, n = 2477). BP was measured using 24‐h BP monitoring (cohort 1) or seated office measurements (cohort 2).
Results
Empagliflozin reduced systolic BP (SBP) and diastolic BP in both cohorts (p < 0.001 vs placebo), without increasing heart rate. Empagliflozin reduced pulse pressure (PP; adjusted mean difference vs placebo cohort 1: −2.3 mmHg; cohort 2: −2.3 mmHg), mean arterial pressure (MAP; cohort 1, −2.3 mmHg; cohort 2, −2.1 mmHg) and double product (cohort 1, −385 mmHg × bpm; cohort 2, −369 mmHg × bpm) all p < 0.001 vs placebo. There was a trend towards a reduction in the ambulatory arterial stiffness index (AASI) with empagliflozin in cohort 1 (p = 0.059 vs placebo). AASI was not measured in cohort 2. Subgroup analyses showed that there were greater reductions in PP with increasing baseline SBP in cohort 1 (p = 0.092). In cohort 2, greater reductions in MAP were achieved in patients with higher baseline SBP (p = 0.027) and greater reductions in PP were observed in older patients (p = 0.011).
Conclusions
Empagliflozin reduced BP and had favourable effects on markers of arterial stiffness and vascular resistance.</description><identifier>ISSN: 1462-8902</identifier><identifier>EISSN: 1463-1326</identifier><identifier>DOI: 10.1111/dom.12572</identifier><identifier>PMID: 26343814</identifier><identifier>CODEN: DOMEF6</identifier><language>eng</language><publisher>Oxford, UK: Blackwell Publishing Ltd</publisher><subject><![CDATA[Aged ; Antidiabetics ; Arteriosclerosis - complications ; Arteriosclerosis - epidemiology ; Arteriosclerosis - prevention & control ; Benzhydryl Compounds - administration & dosage ; Benzhydryl Compounds - adverse effects ; Benzhydryl Compounds - therapeutic use ; Biomarkers ; Blood pressure ; Blood Pressure - drug effects ; Blood Pressure Monitoring, Ambulatory ; cardiovascular disease ; Clinical trials ; Cohort Studies ; Diabetes ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - drug therapy ; Diabetic Angiopathies - epidemiology ; Diabetic Angiopathies - prevention & control ; Dose-Response Relationship, Drug ; Female ; Glucosides - administration & dosage ; Glucosides - adverse effects ; Glucosides - therapeutic use ; Heart rate ; Heart Rate - drug effects ; Humans ; Hypertension - complications ; Hypertension - prevention & control ; Hypoglycemic Agents - administration & dosage ; Hypoglycemic Agents - adverse effects ; Hypoglycemic Agents - therapeutic use ; Male ; Middle Aged ; Original ; phase III study ; Placebos ; Risk ; SGLT2 inhibitor ; type 2 diabetes ; Vascular Resistance - drug effects ; Vascular Stiffness - drug effects]]></subject><ispartof>Diabetes, obesity & metabolism, 2015-12, Vol.17 (12), p.1180-1193</ispartof><rights>2015 The Authors. Diabetes, Obesity and Metabolism published by John Wiley & Sons Ltd.</rights><rights>2015 John Wiley & Sons Ltd</rights><rights>2015. This article is published under http://creativecommons.org/licenses/by-nc/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5792-aa63988d9453ac06bbcfbc4229cbc1899e915980a22f3896bab188d8af6c16e53</citedby><cites>FETCH-LOGICAL-c5792-aa63988d9453ac06bbcfbc4229cbc1899e915980a22f3896bab188d8af6c16e53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fdom.12572$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fdom.12572$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26343814$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Chilton, R.</creatorcontrib><creatorcontrib>Tikkanen, I.</creatorcontrib><creatorcontrib>Cannon, C. P.</creatorcontrib><creatorcontrib>Crowe, S.</creatorcontrib><creatorcontrib>Woerle, H. J.</creatorcontrib><creatorcontrib>Broedl, U. C.</creatorcontrib><creatorcontrib>Johansen, O. E.</creatorcontrib><title>Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes</title><title>Diabetes, obesity & metabolism</title><addtitle>Diabetes Obes Metab</addtitle><description>Aims
To determine the effects of empagliflozin on blood pressure (BP) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus (T2DM).
Methods
We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 12 weeks' empagliflozin and four phase III trials in patients with T2DM receiving 24 weeks' empagliflozin (cohort 1, n = 823; cohort 2, n = 2477). BP was measured using 24‐h BP monitoring (cohort 1) or seated office measurements (cohort 2).
Results
Empagliflozin reduced systolic BP (SBP) and diastolic BP in both cohorts (p < 0.001 vs placebo), without increasing heart rate. Empagliflozin reduced pulse pressure (PP; adjusted mean difference vs placebo cohort 1: −2.3 mmHg; cohort 2: −2.3 mmHg), mean arterial pressure (MAP; cohort 1, −2.3 mmHg; cohort 2, −2.1 mmHg) and double product (cohort 1, −385 mmHg × bpm; cohort 2, −369 mmHg × bpm) all p < 0.001 vs placebo. There was a trend towards a reduction in the ambulatory arterial stiffness index (AASI) with empagliflozin in cohort 1 (p = 0.059 vs placebo). AASI was not measured in cohort 2. Subgroup analyses showed that there were greater reductions in PP with increasing baseline SBP in cohort 1 (p = 0.092). In cohort 2, greater reductions in MAP were achieved in patients with higher baseline SBP (p = 0.027) and greater reductions in PP were observed in older patients (p = 0.011).
Conclusions
Empagliflozin reduced BP and had favourable effects on markers of arterial stiffness and vascular resistance.</description><subject>Aged</subject><subject>Antidiabetics</subject><subject>Arteriosclerosis - complications</subject><subject>Arteriosclerosis - epidemiology</subject><subject>Arteriosclerosis - prevention & control</subject><subject>Benzhydryl Compounds - administration & dosage</subject><subject>Benzhydryl Compounds - adverse effects</subject><subject>Benzhydryl Compounds - therapeutic use</subject><subject>Biomarkers</subject><subject>Blood pressure</subject><subject>Blood Pressure - drug effects</subject><subject>Blood Pressure Monitoring, Ambulatory</subject><subject>cardiovascular disease</subject><subject>Clinical trials</subject><subject>Cohort Studies</subject><subject>Diabetes</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - drug therapy</subject><subject>Diabetic Angiopathies - epidemiology</subject><subject>Diabetic Angiopathies - prevention & control</subject><subject>Dose-Response Relationship, Drug</subject><subject>Female</subject><subject>Glucosides - administration & dosage</subject><subject>Glucosides - adverse effects</subject><subject>Glucosides - therapeutic use</subject><subject>Heart rate</subject><subject>Heart Rate - drug effects</subject><subject>Humans</subject><subject>Hypertension - complications</subject><subject>Hypertension - prevention & control</subject><subject>Hypoglycemic Agents - administration & dosage</subject><subject>Hypoglycemic Agents - adverse effects</subject><subject>Hypoglycemic Agents - therapeutic use</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Original</subject><subject>phase III study</subject><subject>Placebos</subject><subject>Risk</subject><subject>SGLT2 inhibitor</subject><subject>type 2 diabetes</subject><subject>Vascular Resistance - drug effects</subject><subject>Vascular Stiffness - drug effects</subject><issn>1462-8902</issn><issn>1463-1326</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp9kk1v1DAQhiMEomXhwB9AlrjAIa0_Eie-IKGl20Va2guIo-U449YlG6d20rLc-d9Md9sVIIEvHsnPvJ6PN8teMnrE8By3YX3EeFnxR9khK6TImeDy8Tbmea0oP8iepXRFKS1EXT3NDrgUGLHiMPt54hzYMZHgCKwHc9F514UfviehJ00XQkuGCClNEYjpW7I28RvELW7iCNGbjqTRO9cjtCVuTLJTZyLBNJ9G01sgKDeY0UOPH9368ZKMmwEIJ603DYyQnmdPnOkSvLi_Z9mXxcnn-TJfnZ9-nL9f5basFM-NkULVdauKUhhLZdNY19iCc2Uby2qlQLFS1dRw7kStZGMahnhtnLRMQilm2bud7jA1a2gtFhRNp4fosa-NDsbrP196f6kvwo0uKU5XKRR4cy8Qw_UEadRrnyx0nekhTEmzite8rAsc8Cx7_Rd6FabYY3ta0FIVtLhr4z8UalVlJWUlkHq7o2wMKUVw-5IZ1XcW0GgBvbUAsq9-73FPPuwcgeMdcOs72PxbSX84__Qgme8ycJ_wfZ-BVtBYXVXqr2enenG2lHOxXOiV-AWBOswK</recordid><startdate>201512</startdate><enddate>201512</enddate><creator>Chilton, R.</creator><creator>Tikkanen, I.</creator><creator>Cannon, C. P.</creator><creator>Crowe, S.</creator><creator>Woerle, H. J.</creator><creator>Broedl, U. C.</creator><creator>Johansen, O. E.</creator><general>Blackwell Publishing Ltd</general><general>Wiley Subscription Services, Inc</general><scope>BSCLL</scope><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>201512</creationdate><title>Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes</title><author>Chilton, R. ; Tikkanen, I. ; Cannon, C. P. ; Crowe, S. ; Woerle, H. J. ; Broedl, U. C. ; Johansen, O. E.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c5792-aa63988d9453ac06bbcfbc4229cbc1899e915980a22f3896bab188d8af6c16e53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Aged</topic><topic>Antidiabetics</topic><topic>Arteriosclerosis - complications</topic><topic>Arteriosclerosis - epidemiology</topic><topic>Arteriosclerosis - prevention & control</topic><topic>Benzhydryl Compounds - administration & dosage</topic><topic>Benzhydryl Compounds - adverse effects</topic><topic>Benzhydryl Compounds - therapeutic use</topic><topic>Biomarkers</topic><topic>Blood pressure</topic><topic>Blood Pressure - drug effects</topic><topic>Blood Pressure Monitoring, Ambulatory</topic><topic>cardiovascular disease</topic><topic>Clinical trials</topic><topic>Cohort Studies</topic><topic>Diabetes</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - drug therapy</topic><topic>Diabetic Angiopathies - epidemiology</topic><topic>Diabetic Angiopathies - prevention & control</topic><topic>Dose-Response Relationship, Drug</topic><topic>Female</topic><topic>Glucosides - administration & dosage</topic><topic>Glucosides - adverse effects</topic><topic>Glucosides - therapeutic use</topic><topic>Heart rate</topic><topic>Heart Rate - drug effects</topic><topic>Humans</topic><topic>Hypertension - complications</topic><topic>Hypertension - prevention & control</topic><topic>Hypoglycemic Agents - administration & dosage</topic><topic>Hypoglycemic Agents - adverse effects</topic><topic>Hypoglycemic Agents - therapeutic use</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Original</topic><topic>phase III study</topic><topic>Placebos</topic><topic>Risk</topic><topic>SGLT2 inhibitor</topic><topic>type 2 diabetes</topic><topic>Vascular Resistance - drug effects</topic><topic>Vascular Stiffness - drug effects</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chilton, R.</creatorcontrib><creatorcontrib>Tikkanen, I.</creatorcontrib><creatorcontrib>Cannon, C. P.</creatorcontrib><creatorcontrib>Crowe, S.</creatorcontrib><creatorcontrib>Woerle, H. J.</creatorcontrib><creatorcontrib>Broedl, U. C.</creatorcontrib><creatorcontrib>Johansen, O. E.</creatorcontrib><collection>Istex</collection><collection>Wiley Online Library Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Diabetes, obesity & metabolism</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chilton, R.</au><au>Tikkanen, I.</au><au>Cannon, C. P.</au><au>Crowe, S.</au><au>Woerle, H. J.</au><au>Broedl, U. C.</au><au>Johansen, O. E.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes</atitle><jtitle>Diabetes, obesity & metabolism</jtitle><addtitle>Diabetes Obes Metab</addtitle><date>2015-12</date><risdate>2015</risdate><volume>17</volume><issue>12</issue><spage>1180</spage><epage>1193</epage><pages>1180-1193</pages><issn>1462-8902</issn><eissn>1463-1326</eissn><coden>DOMEF6</coden><abstract>Aims
To determine the effects of empagliflozin on blood pressure (BP) and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes mellitus (T2DM).
Methods
We conducted a post hoc analysis of data from a phase III trial in patients with T2DM and hypertension receiving 12 weeks' empagliflozin and four phase III trials in patients with T2DM receiving 24 weeks' empagliflozin (cohort 1, n = 823; cohort 2, n = 2477). BP was measured using 24‐h BP monitoring (cohort 1) or seated office measurements (cohort 2).
Results
Empagliflozin reduced systolic BP (SBP) and diastolic BP in both cohorts (p < 0.001 vs placebo), without increasing heart rate. Empagliflozin reduced pulse pressure (PP; adjusted mean difference vs placebo cohort 1: −2.3 mmHg; cohort 2: −2.3 mmHg), mean arterial pressure (MAP; cohort 1, −2.3 mmHg; cohort 2, −2.1 mmHg) and double product (cohort 1, −385 mmHg × bpm; cohort 2, −369 mmHg × bpm) all p < 0.001 vs placebo. There was a trend towards a reduction in the ambulatory arterial stiffness index (AASI) with empagliflozin in cohort 1 (p = 0.059 vs placebo). AASI was not measured in cohort 2. Subgroup analyses showed that there were greater reductions in PP with increasing baseline SBP in cohort 1 (p = 0.092). In cohort 2, greater reductions in MAP were achieved in patients with higher baseline SBP (p = 0.027) and greater reductions in PP were observed in older patients (p = 0.011).
Conclusions
Empagliflozin reduced BP and had favourable effects on markers of arterial stiffness and vascular resistance.</abstract><cop>Oxford, UK</cop><pub>Blackwell Publishing Ltd</pub><pmid>26343814</pmid><doi>10.1111/dom.12572</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diabetes, obesity & metabolism, 2015-12, Vol.17 (12), p.1180-1193 |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Aged Antidiabetics Arteriosclerosis - complications Arteriosclerosis - epidemiology Arteriosclerosis - prevention & control Benzhydryl Compounds - administration & dosage Benzhydryl Compounds - adverse effects Benzhydryl Compounds - therapeutic use Biomarkers Blood pressure Blood Pressure - drug effects Blood Pressure Monitoring, Ambulatory cardiovascular disease Clinical trials Cohort Studies Diabetes Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - drug therapy Diabetic Angiopathies - epidemiology Diabetic Angiopathies - prevention & control Dose-Response Relationship, Drug Female Glucosides - administration & dosage Glucosides - adverse effects Glucosides - therapeutic use Heart rate Heart Rate - drug effects Humans Hypertension - complications Hypertension - prevention & control Hypoglycemic Agents - administration & dosage Hypoglycemic Agents - adverse effects Hypoglycemic Agents - therapeutic use Male Middle Aged Original phase III study Placebos Risk SGLT2 inhibitor type 2 diabetes Vascular Resistance - drug effects Vascular Stiffness - drug effects |
| title | Effects of empagliflozin on blood pressure and markers of arterial stiffness and vascular resistance in patients with type 2 diabetes |
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