The Clinical Experience of the Effective Use of Dapagliflozin in Comorbid Cardiac Patients With Concomitant Type 2 Diabetes Mellitus and Arterial Hypertension on the Background of Overweight in Outpatient Setting

Abstract

The aim: To assess the efficacy and safety of dapagliflozin in the treatment of comorbid cardiac patients with type 2 diabetes mellitus (T2DM) in combination with arterial hypertension (AH) and overweight in outpatient setting. Materials and methods: Under observation were 19 patients who were treated in outpatient setting during 2019-2021 for AH and had T2DM, overweight or obesity. As part of complex treatment, patients received dapagliflozin 10 mg once a day for 12 months. Results: The normalization of blood pressure, elimination of heart failure symptoms on the background of increased ejection fraction, improved indicators of the functional capacity of the kidneys, and a decrease in the degree of proteinuria/albuminuria were noted after treatment. The patients had an easier time losing weight (body mass index and waist circumference decreased; p<0.05) and decreased levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C). None of the monitored patients had cases of hypoglycemia or urinary tract infection. The number and/or doses of antihypertensive, hypouricemic and diuretic drugs were gradually reduced. Conclusions: Using dapagliflozin in a standard dose of 10 mg/day in the complex therapy of patients with T2DM in combination with arterial hypertension and overweight contributes not only to the normalization of blood pressure, but also to a reduction in body weight and waist circumference. The proposed therapy can be an alternative for the treatment of patients with T2DM with concomitant overweight or obesity, arterial hypertension, with or without heart and/or renal failure as a first-line antidiabetic drug.

Epidemiology and Clinical Features of Arterial Hypertension in Patients with Type 2 Diabetes Mellitus. Literature Review

“…Серьезным преимуществом этих препаратов у рассматриваемых здесь категории больных с АГ и СД 2 типа является их способность к увеличению выведения натрия, благодаря чему они оказывают и значимый гипотензивный эффект. На механизме этого действия иНГЛТ-2 считаем целесообразным остановиться [9,13,18].…”

“…Отметим здесь, что этот класс лекарственных средств уже включен в обновленные рекомендации по лечению не только СД 2 типа, но и ХСН с низкой, промежуточной и сохранной фракцией выброса левого желудочка (ЛЖ) (как с диабетом, так и без него), а также с хронической болезнью почек (ХБП) (включая как ДНП, так и недиабетические гломерулопатии). В завершение рассмотрения возможностей иНГЛТ-2 отметим также их многообразные дополнительные органопротекторные и плейотропные эффекты, к которым относят: противовоспалительное действие, снижение оксидативного стресса и симпатического тонуса, улучшение вазодилатации, улучшение метаболизма энергии в миокарде, замедление ремоделирования сердца, уменьшение ишемического и реперфузионного повреждения миокарда, снижение урикемии, улучшение аутофагии и лизосомальной деградации, уменьшение массы тела [15,18].…”

The ongoing need to improve long‐term patient survival of pediatric solid organ recipients

“…We have learned about the potential cardiovascular benefits of sodium‐glucose cotransporter 2 inhibitors (SGLT2i), 16 as these medications have been associated with the reduction of skin sodium in sodium MRI studies 17 . SGLT2i are also nephroprotective 16 and reduce hypertension 18 . Do we need to increase counselling about the benefits of a low‐salt diet? 19 Should we perform more sodium MRIs in these patients to individualize the risk assessment?…”

“…and reduce hypertension. 18 Do we need to increase counselling about the benefits of a low-salt diet? 19 Should we perform more sodium MRIs in these patients to individualize the risk assessment?…”