Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2019 Apr 22;17(2):e84353.
doi: 10.5812/ijem.84353. eCollection 2019 Apr.

Cardiovascular and Renal Benefits of SGLT2 Inhibitors: A Narrative Review

Soghra Rabizadeh  1 , Manouchehr Nakhjavani  1 , Alireza Esteghamati  1
Affiliations
Review

Cardiovascular and Renal Benefits of SGLT2 Inhibitors: A Narrative Review

Soghra Rabizadeh et al. Int J Endocrinol Metab. .

Abstract

Context: Most recently developed anti-hyperglycemic drugs have offered cardiovascular and renal benefits. In this narrative review, we discuss the cardiovascular and renal benefits of novel antidiabetic drugs, sodium glucose cotransporter type 2 (SGLT2) inhibitors, in type 2 diabetes.

Evidence acquisition: The literature published in PubMed, Scopus, Web of Science, Google Scholar, and Cochrane library were reviewed up to January 2019. The keywords including SGLT2 inhibitor, type 2 diabetes, cardiovascular effect, and renal effect were used in different combinations.

Results: Cardiovascular disease represents a large health burden in patients with diabetes. The prevention of cardiovascular events is a major concern in the treatment of patients with diabetes. Diabetes is also associated with an increased risk of adverse renal events and diabetic nephropathy is the leading cause of end-stage renal disease worldwide. SGLT2 inhibitors as new glucose-lowering agents act by inhibiting glucose reabsorption in the proximal tubule of the kidney, which is independent of insulin secretion. We reviewed the cardiovascular effects of these drugs including effects on triple MACE (major adverse cardiovascular events), myocardial infarction, heart failure, cardiovascular and all-cause mortality, and stroke, as well as renal effects including albuminuria, serum creatinine, the rate of renal replacement therapy, and renal function over time, along with the mechanisms of these effects.

Conclusions: Given the suboptimal glycemic and cardiovascular risk control in type 2 diabetes, novel therapies such as SGLT2 inhibitors seem to have an important clinical advantage to improve glycemic control and cardiovascular and renal outcomes.

Keywords: Cardiovascular Disease; Chronic Kidney Disease; Diabetes Mellitus; Sodium-Glucose Cotransporter 2 Inhibitors.

PubMed Disclaimer

Figures

Figure 1.
Figure 1.. Probable mechanisms of cardiovascular benefits of SGLT2 inhibitors. Hb, hemoglobin; Hct, hematocrit; BP, blood pressure
See this image and copyright information in PMC

References

    1. Farkouh ME, Boden WE, Bittner V, Muratov V, Hartigan P, Ogdie M, et al. Risk factor control for coronary artery disease secondary prevention in large randomized trials. J Am Coll Cardiol. 2013;61(15):1607–15. doi: 10.1016/j.jacc.2013.01.044. - DOI - PubMed
    1. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed diabetes. JAMA. 2004;291(3):335–42. doi: 10.1001/jama.291.3.335. - DOI - PubMed
    1. Emerging Risk Factors Collaboration, Sarwar N, Gao P, Seshasai SR, Gobin R, Kaptoge S, et al. Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: A collaborative meta-analysis of 102 prospective studies. Lancet. 2010;375(9733):2215–22. doi: 10.1016/s0140-6736(10)60484-9. - DOI - PMC - PubMed
    1. Mukamal KJ, Nesto RW, Cohen MC, Muller JE, Maclure M, Sherwood JB, et al. Impact of diabetes on long-term survival after acute myocardial infarction: Comparability of risk with prior myocardial infarction. Diabetes Care. 2001;24(8):1422–7. doi: 10.2337/diacare.24.8.1422. - DOI - PubMed
    1. Alemi H, Khaloo P, Mansournia MA, Rabizadeh S, Salehi SS, Mirmiranpour H, et al. Pulse pressure and diabetes treatments: Blood pressure and pulse pressure difference among glucose lowering modality groups in type 2 diabetes. Medicine (Baltimore). 2018;97(6):e9791. doi: 10.1097/MD.0000000000009791. - DOI - PMC - PubMed

LinkOut - more resources