Evidence mapPaperPMID 36089810Full record

Trial reportDiabetes, obesity & metabolism2023

Mechanisms underlying the blood pressure-lowering effects of empagliflozin, losartan and their combination in people with type 2 diabetes: A secondary analysis of a randomized crossover trial.

Rosalie A Scholtes, Charlotte M Mosterd, Anne C Hesp, Mark M Smits, Hiddo J L Heerspink, Daniël H van Raalte

Open access · hybridAbstract readRandomized Controlled Trial
In one paragraph

Trial report in Diabetes, obesity & metabolism, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 11 citations in OpenAlex.

  1. Trial
  2. Trial
  3. Article
  4. Review
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Rosalie A ScholtesDiabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.ORCID 0000-0002-2794-2263
Charlotte M MosterdDiabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Anne C HespDiabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Mark M SmitsDiabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Hiddo J L HeerspinkDepartment of Clinical Pharmacy and Pharmacology, University Medical Center Groningen, Groningen, The Netherlands.ORCID 0000-0002-3126-3730
Daniël H van RaalteDiabetes Center, Department of Internal Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands.
Amsterdam University Medical Centers · NLUniversity Medical Center Groningen · NLUniversity of Copenhagen · DK

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimTo study the effects of the sodium-glucose co-transporter-2 (SGLT2) inhibitor empagliflozin, the angiotensin receptor blocker (ARB) losartan, and their combination on blood pressure, while studying the mechanisms potentially involved.

methodsA total of 24 people with type 2 diabetes (T2D) (age: 66 ± 6 years; body mass index: 31.0 ± 3 kg/m

resultsVersus placebo (139 mmHg), empagliflozin reduced systolic blood pressure (SBP) by 8 mmHg (P = .001), losartan by 12 mmHg (P = .001) and empagliflozin + losartan by 15 mmHg (P < .001). Combination therapy had a larger SBP-lowering effect versus empagliflozin monotherapy (-7 [95% CI -12; -2] mmHg) and numerically larger effects versus losartan monotherapy (-3 [-8; 2] mmHg). Empagliflozin reduced sympathetic nervous system (SNS) activity, arterial stiffness and extracellular fluid, while increasing serum albumin. Losartan reduced SNS activity and arterial stiffness. Combination therapy induced volume contraction variables, together with a reduction in SNS activity and arterial stiffness.

conclusionIn people with T2D, SGLT2 inhibition in combination with an ARB had a larger blood pressure-lowering effect versus placebo than either of the drugs alone. Our data further suggest that the mechanisms underlying these blood pressure reductions at least partially differ between these agents.

Indexed as

Diabetes Mellitus, Type 2LosartanAgedAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsBlood PressureCross-Over StudiesHumansMiddle AgedSerum AlbuminAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsLosartanSerum Albuminangiotensin receptor blockerautonomic nervous system activityblood pressureempagliflozinlosartanSGLT2 inhibitorsystemic haemodynamic functiontype 2 diabetes

Identifiers

PMID36089810
PMCPMC10087931
OpenAlexW4297457977

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.