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TREATMENT WITH SGLT-2 INHIBITORS IN PATIENTS WITH DIABETES MELLITUS AND ESSENTIAL HYPERTENSION – DYNAMIC OF BLOOD PRESSURE VISIT-TO-VISIT VARIABILITY

Minushkina, L.1; Kazakova, A.V.2; Matveeva, L.S.2; Novosad, S.V.2

Journal of Hypertension: June 2018 - Volume 36 - Issue - p e13
doi: 10.1097/01.hjh.0000538997.78835.f1
ORAL SESSION 2A: BLOOD PRESSURE VARIABILITY: PDF Only
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Objective: Aim of study was to elucidate possible dynamic of blood pressure (BP) level and BP visit-to-visit variability in patient with essential hypertension(EH) and diabetes mellitus (DM).

Design and method: We included in to the study 26 patients with EH and DM (13 male and 13 women, mean age 62.5 ± 7.98 years). Mean BMI was 27.4 ± 4.12 kg/m2, mean GFR 69.4 ± 11.87 ml/min/1,73 m2. Patients were treated with DM and EH in accordance with the current recommendations. At the enrollment visit they receive 2,4 ± 1,12 oral hypoglycemic agents in general, 6 patients were treated with insulin. All patients had insufficient glycemic control when enrolled in the study. 13 patients were additionally received empagliflozin 10 mg OD and 13 patients – dapagliflozin 10 mg OD. The participants had their office BP measured during the 12-month follow-up (6 months before treatment with SGLT-2 inhibitors and 6 months after the beginning of treatment). All patients received antihypertensive therapy, 71% of patients had good BP control. Antihypertension treatment was stable during the study. Blood pressure variability calculation was performed per data of electronic ambulatory cards. We defined systolic and diastolic visit-to-visit variability of BP using average real variability.

Results: Mean systolic BP at the inclusion into the study was 130.3 ± 8.47 mm Hg, diastolic BP – 79.6 ± 6.33 mm Hg. Mean systolic BP variability was 9.41 ± 1.83 mm Hg, diastolic BP variability – 6.64 ± 0.51 mm Hg. After the 6 months of treatment with SGLT-2 inhibitors glycemic control was better. Only 1 patient continued to take insulin. At the end of study patients received 1,8 ± 0,83 oral hypoglycemic agents. Systolic blood pressure decreased by 5.2 ± 10.18 mm Hg (p = 0.020) and diastolic - by 2.7 ± 6.11 mm Hg (p = 0.037). BP variability decreased by 4.5 ± 6.45 mm Hg for systolic (p < 0.001) and 0.8 ± 1.79 mm Hg (p = 0.056) for diastolic BP. The dynamics of BP was not different when treated with different hypoglycemic drugs.

Conclusions: Therapy with SGLT-2 inhibitors improves blood pressure control and decrease BP visit-to-visit variability in patients with EH and DM.

1Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia

2Policlinic 2 of Department of Presidential Affairs, Moscow, Russia

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