Lowering Blood Pressure with the Combination of a Sodium-Glucose Cotransporter 2 Inhibitor and a Glucagon-like Peptide-1 Receptor Agonist in Type 2 Diabetic Patients: A Clinical Evidence

Abstract

Introduction: Patients with type 2 diabetes mellitus (T2DM) often have numerous cardiovascular risk factors, among which hypertension.

Aim: To evaluate the blood pressure variations among patients treated with a combination of a sodium-glucose cotransporter 2 inhibitor (iSGLT-2) and a glucagon-like peptide-1 receptor agonist (GLP-1ra).

Methods: We analyze 17 patients treated with this combination to quantify the changes on blood pressure by ambulatory blood pressure monitoring at baseline and at three and 6 months follow-up.

Results: We observed a decrease of HbA1c levels (p = 0.004) at six months follow-up, a decrease in mean 24 h systolic blood pressure [from 124 (11) mmHg to 123 (4.75) mmHg, p = 0.04] and in both, mean waking and sleeping systolic blood pressure, being greater the reduction in the sleeping time [118 (20) mmHg to 111 (20) mmHg, p = 0.004].

Conclusion: The effect of a combination therapy of an iSGLT-2 and a GLP-1ra on blood pressure in a real-world setting, may have summative effects especially in SBP.

Keywords: Ambulatory blood pressure monitoring; Diabetes; Glucagon-like peptide-1 receptor agonist; Sodium-glucose cotransporter 2 inhibitor.