The article provides information about the use of SGLT2 inhibitors in hypertensive crises, mechanisms of action as an antihypertensive drug and the normalization of endothelial function. Other generation of these drugs are also compared with empagliflazin. Studies have been conducted with placebo drugs, and information is given on the effect of drugs on reducing daily and night blood pressure.


diabetes hypertension glucose weight loss


How to Cite
Raimzhanov A.A, & Mangasaryan A.A. (2023). SGLT2 Inhibitors and Mechanisms of Arterial Hypertension. Texas Journal of Medical Science, 18, 13–16. https://doi.org/10.62480/tjms.2023.vol18.pp13-16


  1. Fuller J.H. Epidemiology of hypertension associated with diabetes mellitus. Hypertension. 1985;7(6 Pt 2):II3–7.
  2. Epstein M, Sowers JR. Diabetes mellitus and hypertension. Hypertension. 1992;19(5):403–18. https://doi.org/10.1161/01. HYP.19.5.403.
  3. Cruickshank K, Riste L, Anderson SG, Wright JS, Dunn G, Gosling RG. Aortic pulse-wave velocity and its relationship to mortality in diabetes and glucose intolerance: an integrated index of vascular function? Circulation. 2002;106(16):2085–90. https://doi.org/10. 1161/01.CIR.0000033824.02722.F7.
  4. Cherney DZ, et al. The effect of empagliflozin on arterial stiffness and heart rate variability in subjects with uncomplicated type 1 diabetes mellitus. Cardiovasc Diabetol. 2014;13(1):28. https://doi.org/10.1186/1475-2840-13-28.
  5. Nosadini R, Sambataro M, Thomaseth K, Pacini G, Cipollina MR, Brocco E, et al. Role of hyperglycemia and insulin resistance in determining sodium retention in non-insulin-dependent diabetes. Kidney Int. 1993;44(1):139–46. https://doi.org/10.1038/ki.1993.224.
  6. Effect of intensive blood-glucose control with metformin on complications in overweight patients with type 2 diabetes (UKPDS 34). UK Prospective Diabetes Study (UKPDS) Group. Lancet, 1998. 352(9131): p. 854–65.
  7. DeFronzo RA, Norton L, Abdul-Ghani M. Renal, metabolic and cardiovascular considerations of SGLT2 inhibition. Nat Rev Nephrol. 2017;13(1):11–26. Comprehensive review paper discussing all the relevant literature regarding metabolic and hemodynamic effects of the SGLT 2 class.
  8. Bailey CJ. Renal glucose reabsorption inhibitors to treat diabetes. Trends Pharmacol Sci. 2011;32(2):63–71. https://doi.org/10.1016/j.tips.2010.11.011.
  9. Thomson SC, Rieg T, Miracle C, Mansoury H, Whaley J, Vallon V, et al. Acute and chronic effects of SGLT2 blockade on glomerular and tubular function in the early diabetic rat. Am J Physiol Regul Integr Comp Physiol. 2012;302(1):R75–83. https://doi.org/10.1152/ajpregu.00357.2011.
  10. Mancia G, Cannon CP, Tikkanen I, Zeller C, Ley L, Woerle HJ, et al. Impact of empagliflozin on blood pressure in patients with type 2 diabetes mellitus and hypertension by background antihypertensive medication. Hypertension. 016;68(6):1355–64. https://doi.org/10.1161/HYPERTENSIONAHA.116.07703.
  11. Plosker GL. Dapagliflozin: a review of its use in type 2 diabetes mellitus. Drugs.2;72(17):2289–312. https://doi.org/10.2165/11209910-000000000-00000.
  12. Lamos EM, Younk LM, Davis SN. Canagliflozin , an inhibitor of sodium-glucose cotransporter 2, for the treatment of type 2 diabetes mellitus. Expert Opin Drug Metab Toxicol. 2013; 9 (6): 763–75.
  13. https://doi.org/10.1517/17425255.2013.791282.
  14. Scheen AJ. Pharmacokinetic and pharmacodynamic profile of empagliflozin, a sodium glucose co-transporter 2 inhibitor. Clin Pharmacokinet. 2014;53(3):213–25. https://doi.org/10.1007/s40262-013-0126-x.
  15. Nauck MA. Update on developments with SGLT2 inhibitors in the management of type 2 diabetes. Drug Des Devel Ther. 2014;8:1335–80. https://doi.org/10.2147/DDDT.S50773.
  16. Zinman B, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med. 2015;373(22):2117–28. Major CV outcome trial with empagliflozin demonstrating reduced CV risk and renoprotection.
  17. Neal, B., et al., Canagliflozin and cardiovascular and renal events in type 2 diabetes. N Engl J Med, 2017.-online. Second major CV outcome trial with canagliflozin that is consistent with empagliflozin data and demonstrates major reduction in CV risk in type 2 diabetes patients.
  18. Wright EM, Loo DD, Hirayama BA. Biology of human sodium glucose transporters. Physiol Rev. 2011;91(2):733–94.
  19. https://doi.org/10.1152/physrev.00055.2009.
  20. Hediger MA, Rhoads DB. Molecular physiology of sodium glucose cotransporters. Physiol Rev. 1994;74(4):993–1026.
  21. https://doi.org/10.1152/physrev.1994.74.4.993.
  22. DeFronzo RA, Hompesch M, Kasichayanula S, Liu X, Hong Y, Pfister M, et al. Characterization of renal glucose reabsorption in response to dapagliflozin in healthy subjects and subjects with type 2 diabetes. Diabetes Care. 013;36(10):3169–76. https://doi.org/10.2337/dc13-0387.
  23. Gerich JE. Role of the kidney in normal glucose homeostasis and in the hyperglycaemia of diabetes mellitus: therapeutic implications. Diabet Med. 2010;27(2):136–42. https://doi.org/10.1111/j.1464-5491.2009.02894.x.