Does empagliflozin help lower blood pressure in patients with diabetes and high night time blood pressure?

The aim of this study was to monitor blood pressure changes with empagliflozin (Jardiance) treatment and normal blood pressure treatment in patients with type 2 diabetes (T2D) and uncontrolled night time high blood pressure. The main finding of the study was that these patients had reductions in their blood pressure when empagliflozin was added to their normal blood pressure and diabetes medications.

Normally, blood pressure lowers at night time. In some people, this does not happen (non-dipper pattern). In some people with high blood pressure, it also remains high at night time (night-time hypertension). Patients with night-time hypertension (HTN) and/or non-dipper patterns are also at high risk for heart disease and heart failure. Patients with T2D are also at a higher risk of heart disease.

Empagliflozin is a drug used in the treatment of T2D. It works by preventing glucose from being taken back up into the body after it is filtered out of the blood in the kidney. Instead, the glucose is removed from the body in the urine. Empagliflozin has shown to improve weight loss and lower blood pressure. However, its effects on nighttime HTN are not known.

This study included 132 patients with T2D and uncontrolled night time HTN. These patients were already receiving blood pressure and diabetes medications. Patients were randomly assigned to receive either empagliflozin 10mg daily or a placebo daily for 12 weeks.

After 12 weeks, patients who were treated with empagliflozin had significantly reduced nighttime blood pressure compared to the placebo group. Patients treated with empagliflozin also had significantly larger reductions in their morning, day-time and 24-hour blood pressure compared to the placebo. There were small reductions in body weight and HbA1c (blood test measuring blood glucose control over the past 3 months) in patients treated with empagliflozin. After 4 weeks, there were significantly lower pro-B-type natriuretic peptide (blood test indicating heart failure) levels in patients treated with empagliflozin compared to those treated with the placebo.

The authors concluded that empagliflozin significantly lowered blood pressure in patients with T2D and high nighttime blood pressure.

This study was funded by Boehringer Ingelheim & Eli Lilly, the developer of empagliflozin. This study was based in Japan. The results may not apply to all populations.