Empagliflozin for Patients With Presumed Resistant Hypertension: A Post Hoc Analysis of the EMPA-REG OUTCOME Trial

• Type: Article in International Scientific Journal
• Date: 2020

Authors

Ferreira, JP (Author) FMUP; Fitchett, D (Author) Other; Ofstad, AP (Author) Other; Kraus, BJ (Author) Other; Wanner, C (Author) Other; Zwiener, I (Author) Other; Zinman, B (Author) Other; Lauer, S (Author) Other; George, JT (Author) Other; Rossignol, P (Author) Other; Zannad, F (Author) Other

Journal

Title: American Journal of Hypertension

Vol. 33

Pages: 1092-1101

ISSN: 0895-7061

Publisher: Oxford University Press

Other information

Authenticus ID: P-00V-8Q7

DOI: 10.1093/ajh/hpaa073

Abstract (EN): <jats:title>Abstract</jats:title> <jats:sec> <jats:title>BACKGROUND</jats:title> <jats:p>Type 2 diabetes (T2D) and resistant hypertension often coexist, greatly increasing risk of target-organ damage and death. We explored the effects of empagliflozin in patients with and without presumed resistant hypertension (prHT) in a post hoc analysis of EMPA-REG OUTCOME (NCT01131676).</jats:p> </jats:sec> <jats:sec> <jats:title>METHODS</jats:title> <jats:p>Overall, 7,020 patients received empagliflozin 10, 25 mg, or placebo with median follow-up of 3.1 years. We defined baseline prHT as ¿3 classes of antihypertensive drugs including a diuretic and uncontrolled blood pressure (BP; systolic blood pressure (SBP) ¿140 and/or diastolic blood pressure ¿90 mm Hg) or ¿4 classes of antihypertensive, including a diuretic, and controlled BP. We explored the effect of empagliflozin on cardiovascular (CV) death, heart failure (HF) hospitalization, 3-point major adverse cardiac events, all-cause death, and incident/worsening nephropathy by Cox regression and BP over time by a mixed-repeated-measures-model analysis.</jats:p> </jats:sec> <jats:sec> <jats:title>RESULTS</jats:title> <jats:p>1,579 (22.5%) patients had prHT. The mean difference in change in SBP from baseline to week 12 vs. placebo was ¿4.5 (95% confidence interval, ¿5.9 to ¿3.1) mm Hg (P < 0.001) in prHT and ¿3.7 (¿4.5, ¿2.9) mm Hg (P < 0.001) in patients without prHT. SBP was more frequently controlled (<130/80 mm Hg) with empagliflozin than with placebo. Patients with prHT had 1.5- to 2-fold greater risk of HF hospitalization, incident/worsening nephropathy, and CV death compared with those without prHT. Empagliflozin improved all outcomes in patients with and without prHT (interaction P > 0.1 for all outcomes).</jats:p> </jats:sec> <jats:sec> <jats:title>CONCLUSIONS</jats:title> <jats:p>Empagliflozin induced a clinically relevant reduction in SBP and consistently improved all outcomes regardless of prHT status. Due to these dual effects, empagliflozin should be considered for patients with hypertension and T2D.</jats:p> </jats:sec>

Language: English

Type (Professor's evaluation): Dissemination