Author(s):
Samah Hammoud, Arige Boubou, Nisrin Kaddar
Email(s):
samahhammod02@gmail.com
DOI:
10.52711/0974-360X.2024.00128 
Address:
Samah Hammoud1*, Arige Boubou2, Nisrin Kaddar3
1Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tishreen University, Lattakia, Syria.
2Department of Internal Medicine (Endocrinology), Faculty of Medicine, Tishreen University, Lattakia, Syria.
3Department of Pharmaceutics and Pharmaceutical Technology, Faculty of Pharmacy, Tishreen University, Lattakia, Syria.
*Corresponding Author
Published In:
Volume - 17,
Issue - 2,
Year - 2024
ABSTRACT:
Hypertension (HTN) and type II diabetes mellitus (T2DM) are two main cardiovascular risk factors that coexist frequently. The aim of this study is evaluation the antihypertensive effect of dapagliflozin in hypertensive type 2 diabetic patients (controlled/inadequately uncontrolled), and study its effect on contributing factors in that effectiveness (ex. weight loss and SNS damping). Primary endpoints included the effect of dapagliflozin on hemoglobin A1C (HbA1c) and blood pressure. Secondary endpoints included the effect of drug on weight body, pulse rate and pulse pressure. Patients were randomly selected from the outpatient of the Endocrinology Department at Tishreen University Hospital in Syria, and divided into two groups: dapagliflozin group (n=45) received 5 or 10mg dapagliflozin once daily as an add-on therapy to oral anti-diabetic drugs (OAD)and antihypertensive drugs, and control group (n=38) received OAD and antihypertensive drugs. After 12 weeks follow-up, dapagliflozin-treated versus control-treated showed significant reduction in HbA1C (-0.7% vs -0.3%, p<0.05, mean seated SBP (-9.4 vs -1.2mmHg, p=0.0001) and mean seated DBP(-6 vs-0.3mmHg, p=0.0001). Dapagliflozin also reduced body weight compared with control (-2.6 vs -0.6kg, p=0.0001) andthere was a significant positive correlation between weight loss and BP reduction. The effect on pulse rate was modest and similar between two groups but dapagliflozin have lowered pulse pressure values. There was no significant dose-response with any studied parameter, too. 5mg dapagliflozin once daily improved glycemic control, reduced body weight, SBP more than DBP and thus improved pulse pressure. All that without any significant effect on pulse rate.
Cite this article:
Samah Hammoud, Arige Boubou, Nisrin Kaddar. Antihypertensive effect of Dapagliflozin in Type II diabetic patients with Hypertension. Research Journal of Pharmacy and Technology. 2024; 17(2):827-3. doi: 10.52711/0974-360X.2024.00128
Cite(Electronic):
Samah Hammoud, Arige Boubou, Nisrin Kaddar. Antihypertensive effect of Dapagliflozin in Type II diabetic patients with Hypertension. Research Journal of Pharmacy and Technology. 2024; 17(2):827-3. doi: 10.52711/0974-360X.2024.00128 Available on: https://rjptonline.org/AbstractView.aspx?PID=2024-17-2-56
REFERENCES:
1. Khalil, L., A. Boubou, and N. Kaddar, Effect of dapagliflozin on serum uric acid in type 2 diabetes mellitus patients. Research Journal of Pharmacy and Technology, 2022. 15(11): 4994-4998. DOI : 10.52711/0974-360X.2022.00839
2. Ahmed, D. and R. Makhous, Evaluation of the effect of metformin therapy on tsh serum levels in diabetic patients. Research Journal of Pharmacy and Technology, 2020. 13(8): 3801-3806. DOI : 10.5958/0974-360X.2020.00673.3
3. Geetha, P. and P. Shanmugasundaram, A Prospective Observational Study on assessment of risk factor associated with diabetic retinopathy in patients diagnosed with type 2 Diabetes Mellitus in south Indian population. Research Journal of Pharmacy and Technology, 2019; 12(2): 595-599.
4. Preethikaa, S. and M. Brundha, Awareness of diabetes mellitus among general population. Research Journal of Pharmacy and Technology, 2018; 11(5): 1825-1829. DOI : 10.5958/0974-360X.2018.00339.6
5. Chowdary, R.P., D. Praveen, and V.M. Aanandhi, A prospective study on incidence of dyslipidemia in diabetes mellitus. Research Journal of Pharmacy and Technology, 2017; 10(2): 431-433.DOI : 10.5958/0974-360X.2017.00086.5
6. Turner, R., et al., Hypertension in diabetes study (Hds). 1. Prevalence of hypertension in newly presenting Type-2 diabetic-patients and the association with risk-factors for cardiovascular and diabetic complications. Journal of hypertension, 1993; 11(3). https://doi.org/10.1097/00004872-199303000-00012
7. Lago, R.M., P.P. Singh, and R.W. Nesto, Diabetes and hypertension. Nature clinical practice Endocrinology & metabolism, 2007; 3(10): 667-667. https://doi.org/10.1038/ncpendmet0638
8. Wang, Z., T. Yang, and H. Fu, Prevalence of diabetes and hypertension and their interaction effects on cardio-cerebrovascular diseases: a cross-sectional study. BMC Public Health, 2021; 21(1): 1-9. ttps://doi.org/10.1186/s12889-021-11122-y
9. Asaad, R.A., The association between Triglyceride-Glucose index and Hypertension statues (stages and phenotypes) in Type II Diabetes Mellitus. Research Journal of Pharmacy and Technology, 2023; 16(6): 2963-2968. DOI: 10.52711/0974-360X.2023.00489
10. Sun, H., et al., IDF Diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045. Diabetes Research and Clinical Practice, 2022; 183: 109119https://doi.org/10.1016/j.diabres.2021.109119.
11. Auad, R., A. Kakaje, and Z. Alourfi, Prediabetes in Syria and Its Associated Factors: A Single-Center Cross-Sectional Study. Diabetes Therapy. 2022: 1-11. https://doi.org/10.1007/s13300-022-01293-1
12. Poretsky, L. Principles of Diabetes Mellitus. 2017; Available from: https://link.springer.com/referencework/10.1007/978-3-319-18741-9. https://doi.org/10.1007/978-0-387-09841-8
13. Kamtekar, S. and V. Keer, Management of diabetes: a review. Diabetes. 2014; 7(9): 1065-1072.
14. Lastra, G., et al., Type 2 diabetes mellitus and hypertension: an update. Endocrinology and Metabolism Clinics. 2014; 43(1): 103-122. DOI:https://doi.org/10.1016/j.ecl.2013.09.005
15. Ohishi, M., Hypertension with diabetes mellitus: physiology and pathology. Hypertension Research. 2018; 41(6): 389-393. https://doi.org/10.1038/s41440-018-0034-4
16. Fuller, J.H., Epidemiology of hypertension associated with diabetes mellitus. Hypertension. 1985; 7(6_pt_2): II3.https://doi.org/10.1161/01.HYP.7.6
17. Acharya, L.D., et al., Trends in prescribing antihypertensive medications and lipid lowering therapy in type-2 diabetic patients in South Indian Tertiary care hospital. Asian Journal of Research in Chemistry. 2016; 9(7): 857. DOI:10.5958/0974-360X.2016.00162.1
18. Eguchi, K., Blood pressure management in patients with type 2 diabetes. Internal Medicine. 2015; 54(18): 2285-2289. https://doi.org/10.2169/internalmedicine.54.5617
19. Arauz-Pacheco, C., M.A. Parrott, and P. Raskin, The treatment of hypertension in adult patients with diabetes. Diabetes care. 2002; 25(1): 134-147. https://doi.org/10.2337/diacare.25.1.134
20. De Boer, I.H., et al., Diabetes and hypertension: a position statement by the American Diabetes Association. Diabetes care. 2017; 40(9): 1273-1284. https://doi.org/10.2337/dci17-0026
21. Sriram, S., A.A. Elizabeth, and L. Akila, Cost Analysis of SGLT2 Inhibitors in patients with type 2 Diabetes in India. Research Journal of Pharmacy and Technology. 2020; 13(12): 5861-5865. DOI : 10.5958/0974-360X.2020.01021.5
22. Gaikwad, A.V. and P. Khulbe, A Comprehensive Review on various HPLC based Analytical techniques used for the Estimation of SGLT2 inhibitors type of Antidiabetic drugs in various dosage forms. Research Journal of Pharmacy and Technology. 2020; 13(9): 4484-4490. DOI : 10.5958/0974-360X.2020.00791.X
23. Vallianou, N.G., E. Geladari, and C.E. Kazazis, SGLT-2 inhibitors: Their pleiotropic properties. Diabetes & Metabolic Syndrome: Clinical Research & Reviews. 2017; 11(4): 311-315. https://doi.org/10.1016/j.dsx.2016.12.003
24. Gnudi, L. and J. Karalliedde, Beat it early: putative renoprotective haemodynamic effects of oral hypoglycaemic agents. Nephrology Dialysis Transplantation. 2016; 31(7): 1036-1043. https://doi.org/10.1093/ndt/gfv093
25. Briasoulis, A., O. Al Dhaybi, and G.L. Bakris, SGLT2 inhibitors and mechanisms of hypertension. Current Cardiology Reports. 2018; 20: 1-7. https://doi.org/10.1007/s11886-018-0943-5
26. Berra, C., et al., Blood pressure control in type 2 diabetes mellitus with arterial hypertension. The important ancillary role of SGLT2-inhibitors and GLP1-receptor agonists. Pharmacological Research. 2020; 160: 105052. https://doi.org/10.1016/j.phrs.2020.105052
27. Jaiswal, A., B.C. Semwal, and S. Singh, A compressive review on novel molecular target of diabetic nephropathy. Research Journal of Pharmacy and Technology. 2022; 15(3): 1398-1404. DOI : 10.52711/0974-360X.2022.00233
28. Weber, M.A., et al., Effects of dapagliflozin on blood pressure in hypertensive diabetic patients on renin–angiotensin system blockade. Blood Pressure. 2016; 25(2): 93-103 .https://doi.org/10.3109/08037051.2015.1116258
29. Sjöström, C.D., et al., Dapagliflozin lowers blood pressure in hypertensive and non-hypertensive patients with type 2 diabetes. Diabetes and Vascular Disease Research. 2015; 12(5): 352-358. https://doi.org/10.1177/1479164115585298
30. Zheng, X.-D., et al., Effects of dapagliflozin on cardiovascular events, death, and safety outcomes in patients with heart failure: a meta-analysis. American Journal of Cardiovascular Drugs. 2021; 21(3): 321-330. https://doi.org/10.1007/s40256-020-00441-x
31. Sjöström, C., et al., Dapagliflozin‐induced weight loss affects 24‐week glycated haemoglobin and blood pressure levels. Diabetes, Obesity and Metabolism. 2015; 17(8): 809-812. https://doi.org/10.1111/dom.12500
32. Matthews, V.B., et al., Role of the sympathetic nervous system in regulation of the sodium glucose cotransporter 2. DOI: https://doi.org/10.1097/HJH.0000000000001434
33. Blankestijn, P.J., C. Wanner, and G. Grassi, Sympathomodulatory effects of sodium–glucose transporter-2 inhibitors in the kidneys and beyond. Journal of hypertension. 2017; 35(10): 1966-1967. DOI: 10.1097/HJH.0000000000001454
34. Whaley, J.M., et al., Targeting the kidney and glucose excretion with dapagliflozin: preclinical and clinical evidence for SGLT2 inhibition as a new option for treatment of type 2 diabetes mellitus. Diabetes, metabolic syndrome and obesity: targets and Therapy. 2012: 135-148.https://doi.org/10.2147/DMSO.S22503
35. Neter, J.E., et al., Influence of weight reduction on blood pressure: a meta-analysis of randomized controlled trials. Hypertension. 2003; 42(5): 878-884. https://doi.org/10.1161/01.HYP.0000094221.86888.AE