INTRODUCTION: The aim of this study was to investigate the effect of sodium-glucose cotransporter-2 (SGLT2) inhibitors on circadian blood pressure rhythm in normotensive patients diagnosed with type 2 diabetes mellitus (DM) who were not on antihypertensives.
METHODS: The study included normotensive patients with type 2 DM who were initiated on SGLT2 inhibitors (empagliflozin, n=31; dapagliflozin, n=36) in addition to an antihyperglycemic agent.
RESULTS: Systolic blood pressure (SBP) and diastolic blood pressure (DBP) changed from a nondipper to a dipper pattern after treatment in 22.4% (n=15) and 25.4% (n=17) of the patients, respectively. Both SBP and DBP changed from a nondipper to a dipper pattern after treatment in 17.9% (n=12) of all patients. This change in circadian blood pressure was not significantly different for the dapagliflozin and empagliflozin groups (p>0.05). Fasting blood sugar and HbA1c levels significantly decreased in both groups after SGLT2 inhibitor treatment (p<0.001). Serum creatinine and spot urine microalbumin levels and the microalbumin/creatinine ratio decreased significantly in both groups (p<0.05). The posttreatment decrease in spot urine protein and creatinine levels was significantly higher in the dapagliflozin group compared to the empagliflozin group (p<0.05).
DISCUSSION AND CONCLUSION: The circadian blood pressure pattern changed from a dipper to a nondipper pattern in normotensive type 2 DM patients after they used SGLT2 inhibitors.