Sodium-Glucose Cotransporter Protein 2 Inhibitors: Novel Application for the Treatment of Obesity-Associated Hypertension

Abstract

Obesity is becoming increasingly prevalent in China and worldwide and is closely related to the development of hypertension. The pathophysiology of obesity-associated hypertension is complex, including an overactive sympathetic nervous system (SNS), activation of the renin-angiotensin-aldosterone system (RAAS), insulin resistance, hyperleptinemia, renal dysfunction, inflammatory responses, and endothelial function, which complicates treatment. Sodium-glucose cotransporter protein 2 (SGLT-2) inhibitors, novel hypoglycemic agents, have been shown to reduce body weight and blood pressure and may serve as potential novel agents for the treatment of obesity-associated hypertension. This review discusses the beneficial mechanisms of SGLT-2 inhibitors for the treatment of obesity-associated hypertension. SGLT-2 inhibitors can inhibit SNS activity, reduce RAAS activation, ameliorate insulin resistance, reduce leptin secretion, improve renal function, and inhibit inflammatory responses. SGLT-2 inhibitors can, therefore, simultaneously target multiple mechanisms of obesity-associated hypertension and may serve as an effective treatment for obesity-associated hypertension.

Keywords: inflammation; metabolism; neuro-humoral regulation; obesity-associated hypertension; sodium-glucose cotransporter protein 2 inhibitors.

Figure 1

The mechanisms of SGLT-2 inhibitors for the treatment of obesity-associated hypertension. Taking sympathetic nervous system, renin-angiotensin-aldosterone system, insulin resistance, hyperleptinemia, renal insufficiency, inflammatory response and endothelial function as the main aspects, can improve the body weight and blood pressure of patients with obesity-related hypertension, and better protect the heart and kidney function.