Evidence mapPaperPMID 40037646Full record

Trial reportEuropean heart journal2025

Empagliflozin in resistant hypertension and heart failure with preserved ejection fraction: the EMPEROR-Preserved trial.

Michael Böhm, Javed Butler, Andrew Coats, Lucas Lauder, Felix Mahfoud, Gerasimos Filippatos, João Pedro Ferreira, Stuart J Pocock, Martina Brueckmann, Sibylle J Hauske and 6 more

Abstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.

0numbers the graph read from it
0cells of the map it votes in
10citing papers in PubMed
field-weighted citation impact
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

10 citing papers in PubMed.

  1. Trial
  2. Review
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  10. 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

16 authors.

Michael BöhmKlinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str.1, Homburg/Saar 66421, Germany.ORCID 0000-0002-2976-2514
Javed ButlerBaylor Scott and White Research Institute, Dallas, TX, USA.
Andrew CoatsHeart Research Institute, Sydney, Australia.
Lucas LauderKlinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str.1, Homburg/Saar 66421, Germany.ORCID 0000-0003-1434-9556
Felix MahfoudKlinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University, Kirrberger Str.1, Homburg/Saar 66421, Germany.ORCID 0000-0002-4425-549X
Gerasimos FilippatosSchool of Medicine, National and Kapodistrian University of Athens, Athens University Hospital Attikon, 1 Rimini St, Athens 12462, Greece.
João Pedro FerreiraCentre d'Investigation Clinique- Plurithématique Inserm CIC-P 1433, Université de Lorraine, Nancy, France.
Stuart J PocockDepartment of Medical Statistics, London School of Hygiene & Tropical Medicine, London, UK.
Martina BrueckmannTherapeutic Area of Cardiorenal and Metabolic Medicine, Boehringer Ingelheim International, Binger Str. 173, Ingelheim 55218, Germany.
Sibylle J HauskeTherapeutic Area of Cardiorenal and Metabolic Medicine, Boehringer Ingelheim International, Binger Str. 173, Ingelheim 55218, Germany.
Elke Schuelermainanalytics GmbH, Sulzbach, Otto-Volger-Str. 3c, Sulzbach/Taunus 65843, Germany.ORCID 0000-0002-5955-8303
Christoph WannerDepartment of Clinical Research and Epidemiology, Comprehensive Heart Failure Center (CHFC), Am Schwarzenberg 15, Würzburg 97078, Germany.ORCID 0000-0001-9507-5301
Subodh VermaDivision of Cardiac Surgery, St Michael's Hospital, Toronto, Ontario, Canada.ORCID 0000-0002-4018-8533
Faiez ZannadInstitut Lorrain du Coeur et des Vaisseaux, Nancy, France.
Milton PackerDepartment of Cardiovascular Science, Baylor University Medical Center, 3500 Gaston Ave, Dallas, TX 75246, USA.ORCID 0000-0003-1828-2387
Stefan D AnkerDepartment of Cardiology (CVK) of German Heart Center Charité, Berlin, Germany.ORCID 0000-0002-0805-8683

Funding

Boehringer Ingelheim
6 · The paper itself

Abstract

BACKGROUND AND

aimsHypertension has a high prevalence in heart failure with preserved ejection fraction (HFpEF), which can be controlled, uncontrolled, or even resistant. The effects of empagliflozin on systolic blood pressure (SBP), time in target range, incidence of hypertensive urgencies, and studied cardiovascular and renal outcomes in different hypertension categories and after treatment with empagliflozin in the EMPEROR-Preserved trial were explored.

methodsA total of 5533 patients were studied and the population was separated into resistant (resHTN), uncontrolled (uctrHTN), and controlled (ctrHTN) hypertension. The effect of SBP on outcomes and treatment effects of empagliflozin were explored. Analyses were done with Cox regression analyses adjusted for demographic and clinical confounders and with a mixed model for repeated measures.

resultsEmpagliflozin reduced SBP in resHTN slightly more than in the other categories in the first weeks, while thereafter there were no significant differences. The modest reduction in SBP resulted in a moderate increase in time at target and reduced hypertensive urgencies. The primary endpoint was more prevalent in resHTN (P = .0358), but the treatment effect of empagliflozin on the primary endpoint was similar in resHTN, uctrHTN, and ctrHTN (P for interaction = .92) as was the improvement of the estimated glomerular filtration rate slope (P for interaction = .95) and change in quality of life by empagliflozin.

conclusionsIn HFpEF, the prevalence of resHTN is high and is associated with frequently higher outcome rates compared with ctrHTN and uctrHTN. The treatment effect was not modified by hypertension categories. This indicates that in HFpEF, moderate modifications of blood pressure do not affect overall outcomes and treatment effects of empagliflozin.

Indexed as

Benzhydryl CompoundsGlucosidesHeart FailureHypertensionSodium-Glucose Transporter 2 InhibitorsAgedAntihypertensive AgentsBlood PressureFemaleHumansMaleMiddle AgedStroke VolumeTreatment OutcomeAntihypertensive AgentsBenzhydryl CompoundsempagliflozinGlucosidesSodium-Glucose Transporter 2 InhibitorsBlood pressure categoriesCardiovascular outcomesControlled hypertensionEmpagliflozinKidney outcomesResistant hypertensionUncontrolled hypertension

Identifiers

PMID40037646
PMCPMC11973566

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.