The goal of a recent study published in Circulation was to analyze the efficacy and safety of dapagliflozin – stratified to the baseline systolic blood pressure (SBP).

The findings revealed that dapagliflozin reduced SBP by 2.4 mm Hg, which was greater than that with placebo after 48 months of therapy. The beneficial effects of dapagliflozin remained comparable across all baseline SBP categories with respect to hospitalization for heart failure (HF) and renal outcomes. There were no reports of a necessity for treatment effect modification. The hazard ratios were 0.66 in normotensive patients and 0.39 for those hospitalized for HF and renal-specific outcome. Meanwhile, events of volume depletion, amputation, and acute kidney injury (AKI) were not altered by dapagliflozin use for any baseline SBP group.

It was concluded that patients with T2DM who are at high risk for atherosclerotic cardiovascular disease (ASCVD), dapagliflozin can reduce the risk for hospitalization due to HF and renal complications, regardless of baseline SBP. While the use of this drug did not impose any difference in adverse events based on the baseline SBP. Thus, dapagliflozin provides cardiorenal benefits in patients with T2DM who are at high ASCVD risk – independent of baseline blood pressure.

Source: Circulation. 2022 May 24;145(21):1581-1591. doi: 10.1161/CIRCULATIONAHA.121.058103.