Effect of Sodium Glucose Co-Transporter 2 Inhibitors on Blood Pressure Time in Therapeutic Range

Purpose: Sodium-glucose co-transporter 2 (SGLT2) inhibitors are antihyperglycemic medications that lower blood glucose levels by altering renal glucose reabsorption. SGLT2 inhibitors reduce blood pressure (BP) levels through increased diuresis and decreased sympathetic tone.[1] Due to these mechanisms, SGLT2 inhibitors are associated with improved cardiovascular and renal outcomes.[2] The objective of this study is to determine the association between SGLT2 inhibitors and BP time in therapeutic range (TTR). Consistent BP control in TTR has been shown to impact all-cause mortality.[3] While known to reduce BP levels, whether SGLT2 inhibitors impact the consistency of BP control has not been studied. Methods: This study is a retrospective chart review of adults with type 2 diabetes treated with SGLT2 inhibitors at UNT Health between January 2015 and September 2019. Patients were identified from an electronic report and excluded if the patient used the medication for < 1 month. Each patient serves as their own matched control, by comparing BP readings before and after SGLT2 inhibitor initiation. The target enrollment of 100 patients will achieve 80% power to detect a minimum of 2.46 mmHg reduction in systolic blood pressure (SBP).[4] A one-tailed p-value of < 0.05 will be considered statistically significant. The primary endpoint is TTR defined as the proportion of time that SBP is between 120 and 140 mmHg during the treatment period.[5] Primary endpoints and baseline characteristics will be compared, using paired t-tests for categorical data and chi square tests for nominal data. Results/Conclusion: In progress