title: Potential role of sodium glucose cotransporter 2 inhibitors in the treatment of hypertension.
abstract: OBJECTIVE
  The majority of patients with type 2 diabetes mellitus (T2DM) have hypertension requiring combination therapy. Sodium glucose cotransporter 2 (SGLT2) inhibitors are novel glucose-lowering drugs with shared and potentially unique beneficial effects on cardiovascular risk beyond glycemic control. This review focuses on the potential role of SGLT2 inhibitors in the treatment of hypertension associated with T2DM.
  
  
  RESULTS
  SGLT2 inhibitors reduce office SBP by 3-5 mmHg and DBP by 2-3 mmHg across all class members. Corresponding clinically meaningful, significant blood pressure (BP) lowering effects have been confirmed using 24 h ambulatory BP monitoring. SGLT2 inhibitors reduce BP irrespective of the type of background antihypertensive medication. The antihypertensive actions of SGLT2 inhibitors involve several mechanisms including modest diuretic effects, weight loss, and direct vascular effects leading to decreased arterial stiffness and vascular resistance. The first-in class cardiovascular outcome trial with empagliflozin showed a significant reduction in a composite endpoint of cardiovascular death, nonfatal stroke, and nonfatal myocardial infarction in T2DM patients at high risk for cardiovascular events.
  
  
  CONCLUSIONS
  SGLT2 inhibitors have clinically significant antihypertensive effects. SGLT2 inhibition could be a potentially useful supplement to the BP-lowering treatment armamentarium in patients with T2DM.
authors.affiliation: aAbdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital bMinerva Institute for Medical Research, Helsinki, Finland cUniversity of Texas Health Science Center, San Antonio, Texas, USA dBoehringer Ingelheim Norway KS, Asker eDepartment of Medical Research, Bærum Hospital, Vestre Viken Hospital Trust, Norway.
authors.forename: Ilkka
authors.initials: I
authors.lastname: Tikkanen
authors.forename: Robert
authors.initials: R
authors.lastname: Chilton
authors.forename: Odd Erik
authors.initials: OE
authors.lastname: Johansen
mesh_terms: D001559:Benzhydryl Compounds / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects*; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000188:drug therapy*; D003925:Diabetic Angiopathies / Q000188:drug therapy*; D004232:Diuretics; D005960:Glucosides / Q000627:therapeutic use; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000188:drug therapy* / Q000378:metabolism; D007004:Hypoglycemic Agents / Q000494:pharmacology / Q000627:therapeutic use*; D051297:Sodium-Glucose Transporter 2 / Q000378:metabolism; D000077203:Sodium-Glucose Transporter 2 Inhibitors; D014655:Vascular Resistance / Q000187:drug effects; D015431:Weight Loss / Q000187:drug effects
chemical_list: D001559:Benzhydryl Compounds; D004232:Diuretics; D005960:Glucosides; D007004:Hypoglycemic Agents; C089180:SLC5A2 protein, human; D051297:Sodium-Glucose Transporter 2; D000077203:Sodium-Glucose Transporter 2 Inhibitors; C570240:empagliflozin