Skip to Main content Skip to Navigation
New interface
Journal articles

Empagliflozin for Patients with Presumed Resistant Hypertension: a Post Hoc Analysis of the EMPA-REG OUTCOME Trial

Abstract : Background: Type 2 diabetes (T2D) and resistant hypertension (rHT) often coexist, greatly increasing risk of target-organ damage and death. We explored the effects of empagliflozin in patients with and without presumed resistant hypertension (prHT) in a post hoc analysis of EMPA-REG OUTCOME (NCT01131676). Methods: Overall, 7020 patients received empagliflozin 10mg, 25mg, or placebo with median follow-up of 3.1 years. We defined baseline prHT as ≥3 classes of antihypertensive drugs including a diuretic and uncontrolled BP (SBP≥140 and/or diastolic BP [DBP]≥90 mmHg), or ≥4 classes of antihypertensive, including a diuretic, and controlled BP. We explored the effect of empagliflozin on CV death, heart failure hospitalization (HHF), 3-point major adverse cardiac events (3P-MACE), all-cause death, and incident/worsening nephropathy by Cox regression and BP over time by a mixed-repeated-measures-model analysis.Results: 1579 (22.5%) patients had prHT. The mean difference in change in SBP from baseline to week 12 versus placebo was -4.5 (95% CI, -5.9 to -3.1) mmHg (p<0.001) in prHT and -3.7 (-4.5, -2.9) mmHg (p<0.001) in patients without prHT. SBP was more frequently controlled (<130/80 mmHg) with empagliflozin than with placebo. Patients with prHT had 1.5 to 2-fold greater risk of HHF, incident/worsening nephropathy and CV death compared to those without prHT. Empagliflozin improved all outcomes in patients with and without prHT (interaction P>0.1 for all outcomes). Conclusions: Empagliflozin induced a clinically relevant reduction in SBP and consistently improved all outcomes regardless of prHT status. Due to these dual effects, empagliflozin should be considered for patients with hypertension and T2D.
Complete list of metadata

Cited literature [38 references]  Display  Hide  Download
Contributor : Erwan BOZEC Connect in order to contact the contributor
Submitted on : Friday, May 15, 2020 - 8:39:25 AM
Last modification on : Wednesday, February 10, 2021 - 11:54:18 AM


Files produced by the author(s)




Joao Pedro Ferreira, David Fitchett, Anne Pernille Ofstad, Bettina Johanna Kraus, Christoph Wanner, et al.. Empagliflozin for Patients with Presumed Resistant Hypertension: a Post Hoc Analysis of the EMPA-REG OUTCOME Trial. American Journal of Hypertension, 2020, 33 (12), ⟨10.1093/ajh/hpaa073⟩. ⟨hal-02585975⟩



Record views


Files downloads