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).
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.
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.
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