Effect of sodium-glucose cotransporter 2 inhibitors on 24-hour ambulatory blood pressure in patients with type-2 diabetes and hypertension: an updated meta-analysis.

BACKGROUND: Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for type 2 diabetes treatment, have shown potential benefits beyond glycemic control, including a positive impact on blood pressure. This meta-analysis aims to evaluate their effects on patients with type 2 diabetes and hypertension.

METHODS: We searched PubMed, Google Scholar, and Cochrane databases for relevant randomized controlled trials (RCTs) published until May 31, 2023. Ten RCTs involving participants with confirmed Type 2 diabetes mellitus were selected. The intervention group received SGLT2 inhibitors, while the control group received a placebo or standard care. Primary outcomes were 24-hour ambulatory systolic and diastolic blood pressures.

RESULTS: The results showed a significant reduction in 24-hour ambulatory systolic blood pressure (WMD = -5.08 mmHg, 95% CI: -7.02 to -3.14, p <0.00001) and diastolic blood pressure (WMD = -2.73 mmHg, 95% CI: -4.25 to -1.20, p = 0.0005) with the use of SGLT2 inhibitors compared to placebo. However, high heterogeneity was observed in both analyses (systolic blood pressure: I2 = 83%; diastolic blood pressure: I2 = 91%). Sensitivity analysis excluding specific studies reduced heterogeneity while maintaining statistically significant and clinically meaningful reductions in blood pressure.

CONCLUSION: In conclusion, this meta-analysis proves that SGLT2 inhibitors significantly reduce 24-hour ambulatory blood pressure. SGLT2 inhibitors may be considered an effective treatment option for lowering blood pressure in addition to standard care in hypertensive patients with type 2 diabetes mellitus.