Evidence mapPaperPMID 42538499Full record

ReviewHigh blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension2026

Efficacy and Safety of SGLT-2 Inhibitors in Patients with Uncontrolled or Resistant Hypertension: A Pilot Meta-Analysis of Randomized Clinical Trials.

Omer Mohammed, Sun Hyeok Kim, Aditya Karthikeyan, Nehal Eid, Raissa Santos Reimann, Afthab Salam Kanniyan, Basil Joy, Ana-Cătălina Dascălu, Giovanni J Nanna, Laura Marcela Romero-Acero and 1 more

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In one paragraph

Review in High blood pressure & cardiovascular prevention : the official journal of the Italian Society of Hypertension, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

11 authors.

Omer Mohammed *Government Medical College, Kozhikode, Kerala, India.ORCID http://orcid.org/0009-0006-6176-4241
Sun Hyeok Kim *Korea University College of Medicine, Seoul, South Korea.ORCID http://orcid.org/0009-0008-9163-3271
Aditya KarthikeyanJacobi Medical Center, Albert Einstein College of Medicine, New York, USA.ORCID http://orcid.org/0009-0006-5005-1211
Nehal EidMansoura University, El Mansoura, Egypt.ORCID http://orcid.org/0009-0005-1385-5176
Raissa Santos ReimannCentro Universitário São Lucas, Porto Velho, Brazil.ORCID http://orcid.org/0000-0001-7860-8727
Afthab Salam KanniyanGovernment Medical College, Kozhikode, Kerala, India.ORCID http://orcid.org/0009-0001-8623-2296
Basil JoyGovernment Medical College, Kozhikode, Kerala, India.ORCID http://orcid.org/0009-0006-0662-4828
Ana-Cătălina DascăluSpitalul Clinic Judetean de Urgenta Târgu Mureş, Târgu Mureş, Romania.ORCID http://orcid.org/0009-0001-2137-1615
Giovanni J NannaZucker School of Medicine at Hofstra/Northwell, New York, USA.
Laura Marcela Romero-AceroCardiac Care and Vascular Medicine, Albert Einstein College of Medicine, 1461 Astor Ave, Bronx, New York, NY, 10469, USA.ORCID http://orcid.org/0000-0002-9851-5509
Michele NannaCardiac Care and Vascular Medicine, Albert Einstein College of Medicine, 1461 Astor Ave, Bronx, New York, NY, 10469, USA. mnannamd@cardiovascularcare.org.ORCID http://orcid.org/0000-0002-9664-6046

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionResistant or poorly controlled hypertension is a major contributor to cardiovascular morbidity and mortality despite contemporary multidrug regimens.

aimThis study aimed to evaluate the efficacy and safety of SGLT-2 inhibitors as adjunctive agents to standard antihypertensive therapy in this high-risk population.

methodsWe systematically searched PubMed, Embase, Google Scholar, the Cochrane Library, ScienceDirect, and ClinicalTrials.gov for randomized controlled trials (RCTs) assessing SGLT-2 inhibitors in adults with poorly controlled hypertension (on ≥2 antihypertensive agents) or resistant hypertension. Primary outcome was the mean change in office systolic blood pressure (SBP). Mean differences (MDs) were pooled for continuous outcomes, and risk ratios (RRs) were pooled for dichotomous outcomes using random-effects models.

resultsFour RCTs (n=3,718) were included in the meta-analysis. SGLT-2 inhibitors significantly reduced office SBP in both the short term (MD -3.29 mmHg, 95% CI -3.96 to -2.62) and long term (MD -2.96 mmHg, 95% CI -3.58 to -2.35). The overall incidence of adverse events (pooled RR: 0.99, 95% CI 0.95 to 1.02), serious adverse events (pooled RR: 0.92, 95% CI 0.84 to 1.00), AKI (pooled RR: 0.98, 95% CI 0.80 to 1.21), and UTI (pooled RR: 0.88, 95% CI 0.36 to 2.17) were comparable between groups. However, SGLT-2 inhibitors were associated with a significantly increased risk of volume depletion, hypotension, and genital infections.

conclusionSGLT-2 inhibitors provide a modest incremental benefit in lowering office SBP for patients with uncontrolled or resistant hypertension on multidrug regimens with an overall acceptable safety profile. Future dedicated RCTs are warranted.

Indexed as

DapagliflozinEmpagliflozinResistant hypertensionSGLT-2 inhibitorsUncontrolled hypertension

Identifiers

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.