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Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis

BACKGROUND: Sodium‐glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antihyperglycemic agents that improve glycemic control by increasing glycosuria. Additional benefits beyond glucose lowering include significant improvements in seated clinic blood pressure (BP), partly attributed to...

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Autores principales: Baker, William L., Buckley, Leo F., Kelly, Michael S., Bucheit, John D., Parod, Eric D., Brown, Roy, Carbone, Salvatore, Abbate, Antonio, Dixon, Dave L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524106/
https://www.ncbi.nlm.nih.gov/pubmed/28522675
http://dx.doi.org/10.1161/JAHA.117.005686
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author Baker, William L.
Buckley, Leo F.
Kelly, Michael S.
Bucheit, John D.
Parod, Eric D.
Brown, Roy
Carbone, Salvatore
Abbate, Antonio
Dixon, Dave L.
author_facet Baker, William L.
Buckley, Leo F.
Kelly, Michael S.
Bucheit, John D.
Parod, Eric D.
Brown, Roy
Carbone, Salvatore
Abbate, Antonio
Dixon, Dave L.
author_sort Baker, William L.
collection PubMed
description BACKGROUND: Sodium‐glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antihyperglycemic agents that improve glycemic control by increasing glycosuria. Additional benefits beyond glucose lowering include significant improvements in seated clinic blood pressure (BP), partly attributed to their diuretic‐like actions. Less known are the effects of this class on 24‐hour ambulatory BP, which is a better predictor of cardiovascular risk than seated clinic BP. METHODS AND RESULTS: We performed a meta‐analysis of randomized, double‐blind, placebo‐controlled trials to investigate the effects of SGLT2 inhibitors on 24‐hour ambulatory BP. We searched all studies published before August 17, 2016, which reported 24‐hour ambulatory BP data. Mean differences in 24‐hour BP, daytime BP, and nighttime BP were calculated by a random‐effects model. SGLT2 inhibitors significantly reduce 24‐hour ambulatory systolic and diastolic BP by −3.76 mm Hg (95% CI, −4.23 to −2.34; I(2)=0.99) and −1.83 mm Hg (95% CI, −2.35 to −1.31; I(2)=0.76), respectively. Significant reductions in daytime and nighttime systolic and diastolic BP were also found. No association between baseline BP or change in body weight were observed. CONCLUSIONS: This meta‐analysis shows that the reduction in 24‐hour ambulatory BP observed with SGLT2 inhibitors is a class effect. The diurnal effect of SGLT2 inhibitors on 24‐hour ambulatory BP may contribute to their favorable effects on cardiovascular outcomes.
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spelling pubmed-55241062017-08-02 Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis Baker, William L. Buckley, Leo F. Kelly, Michael S. Bucheit, John D. Parod, Eric D. Brown, Roy Carbone, Salvatore Abbate, Antonio Dixon, Dave L. J Am Heart Assoc Systematic Review and Meta‐Analysis BACKGROUND: Sodium‐glucose cotransporter 2 (SGLT2) inhibitors are a novel class of antihyperglycemic agents that improve glycemic control by increasing glycosuria. Additional benefits beyond glucose lowering include significant improvements in seated clinic blood pressure (BP), partly attributed to their diuretic‐like actions. Less known are the effects of this class on 24‐hour ambulatory BP, which is a better predictor of cardiovascular risk than seated clinic BP. METHODS AND RESULTS: We performed a meta‐analysis of randomized, double‐blind, placebo‐controlled trials to investigate the effects of SGLT2 inhibitors on 24‐hour ambulatory BP. We searched all studies published before August 17, 2016, which reported 24‐hour ambulatory BP data. Mean differences in 24‐hour BP, daytime BP, and nighttime BP were calculated by a random‐effects model. SGLT2 inhibitors significantly reduce 24‐hour ambulatory systolic and diastolic BP by −3.76 mm Hg (95% CI, −4.23 to −2.34; I(2)=0.99) and −1.83 mm Hg (95% CI, −2.35 to −1.31; I(2)=0.76), respectively. Significant reductions in daytime and nighttime systolic and diastolic BP were also found. No association between baseline BP or change in body weight were observed. CONCLUSIONS: This meta‐analysis shows that the reduction in 24‐hour ambulatory BP observed with SGLT2 inhibitors is a class effect. The diurnal effect of SGLT2 inhibitors on 24‐hour ambulatory BP may contribute to their favorable effects on cardiovascular outcomes. John Wiley and Sons Inc. 2017-05-18 /pmc/articles/PMC5524106/ /pubmed/28522675 http://dx.doi.org/10.1161/JAHA.117.005686 Text en © 2017 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Systematic Review and Meta‐Analysis
Baker, William L.
Buckley, Leo F.
Kelly, Michael S.
Bucheit, John D.
Parod, Eric D.
Brown, Roy
Carbone, Salvatore
Abbate, Antonio
Dixon, Dave L.
Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
title Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
title_full Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
title_fullStr Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
title_full_unstemmed Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
title_short Effects of Sodium‐Glucose Cotransporter 2 Inhibitors on 24‐Hour Ambulatory Blood Pressure: A Systematic Review and Meta‐Analysis
title_sort effects of sodium‐glucose cotransporter 2 inhibitors on 24‐hour ambulatory blood pressure: a systematic review and meta‐analysis
topic Systematic Review and Meta‐Analysis
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5524106/
https://www.ncbi.nlm.nih.gov/pubmed/28522675
http://dx.doi.org/10.1161/JAHA.117.005686
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