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Review
. 2023 Sep;80(9):1800-1809.
doi: 10.1161/HYPERTENSIONAHA.123.20598. Epub 2023 Jul 5.

Functional and Clinical Importance of SGLT2-inhibitors in Frailty: From the Kidney to the Heart

Gaetano Santulli  1   2   3   4 , Fahimeh Varzideh  1   2 , Imma Forzano  3 , Scott Wilson  1 , Luigi Salemme  5 , Antonio de Donato  1 , Angela Lombardi  1 , Antonio Rainone  5 , Luigi Nunziata  6 , Stanislovas S Jankauskas  1   2 , Tullio Tesorio  5 , Germano Guerra  7   4 , Urna Kansakar  1   2 , Pasquale Mone  1   7
Affiliations
Review

Functional and Clinical Importance of SGLT2-inhibitors in Frailty: From the Kidney to the Heart

Gaetano Santulli et al. Hypertension. 2023 Sep.

Abstract

SGLT2 (sodium-glucose cotransporter 2) enables glucose and sodium reabsorption in the kidney. SGLT2-inhibitors (also known as gliflozins, which include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin) act by increasing glycosuria, thereby reducing glycemia. These drugs are critical to reach and keep glycemic control, a crucial feature, especially in patients with comorbidities, like frail individuals. Several studies evaluated the effects of SGLT2-inhibitors in different settings beyond diabetes, revealing that they are actually pleiotropic drugs. We recently evidenced the favorable effects of SGLT2-inhibition on physical and cognitive impairment in frail older adults with diabetes and hypertension. In the present overview, we summarize the latest clinical and preclinical studies exploring the main effects of SGLT2-inhibitors on kidney and heart, emphasizing their potential beneficial actions in frailty.

Keywords: cardiology; endocrinology; frailty; geriatrics; metabolism; nephrology; pharmacology.

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Conflict of interest statement

Disclosures None.

Figures

Figure 1.
Figure 1.
Pleiotropic actions of SGLT2-inhibitors.
Figure 2.
Figure 2.
Main effects of SGLT2-inhibitors on kidney and heart.
See this image and copyright information in PMC

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