Dapagliflozin reduces the white coat effect on systolic blood pressure of patients with type 2 diabetes: a post-hoc analysis from the ADDENDA-BHS 2 trial.

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Current Medical Research and Opinion Pub Date : 2025-01-01 Epub Date: 2024-12-20 DOI:10.1080/03007995.2024.2442040
Pamela Nogueira Cavalcante, Joaquim Barreto, Sheila T Kimura-Medorima, Ikaro Breder, Wilson Nadruz, Andrei C Sposito
{"title":"Dapagliflozin reduces the white coat effect on systolic blood pressure of patients with type 2 diabetes: a <i>post-hoc</i> analysis from the ADDENDA-BHS 2 trial.","authors":"Pamela Nogueira Cavalcante, Joaquim Barreto, Sheila T Kimura-Medorima, Ikaro Breder, Wilson Nadruz, Andrei C Sposito","doi":"10.1080/03007995.2024.2442040","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>White coat effect (WCE) is a phenomenon linked to increased cardiovascular risk, where office blood pressure readings exceed home or ambulatory measurements. Excess weight and elevated blood pressure or glucose are associated with WCE in type 2 diabetes (T2D). This study compared dapagliflozin and glibenclamide on WCE in T2D patients under equivalent blood pressure and glucose control.</p><p><strong>Methods: </strong>This <i>post-hoc</i> analysis of the ADDENDA-BHS2 trial enrolled T2D patients with high cardiovascular risk, defined by stable coronary artery disease or subclinical carotid atherosclerosis. This single-center, open-label, randomized trial included 98 participants, randomized to 12 weeks of dapagliflozin or glibenclamide, in addition to metformin. Baseline blood pressure and glucose control were adjusted to maintain equivalence. This analysis focused on 85 participants with pre- and post-treatment 24-h ambulatory blood pressure data.</p><p><strong>Results: </strong>Despite blood pressure and glucose control, WCE was present in 28% of participants at baseline. Baseline-adjusted change in WCE on systolic BP showed median changes of -8.6 and 1.7 mmHg for dapagliflozin and glibenclamide groups, respectively (<i>p</i> = 0.048). This effect was not observed on diastolic blood pressure.</p><p><strong>Conclusion: </strong>Dapagliflozin reduces WCE on systolic blood pressure compared to glibenclamide, even under equivalent blood pressure and glucose control.</p><p><strong>Clinical trial registration: </strong>The trial was registered at the Clinicaltrials.gov (NCT: 02919345).</p>","PeriodicalId":10814,"journal":{"name":"Current Medical Research and Opinion","volume":" ","pages":"25-29"},"PeriodicalIF":2.4000,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Medical Research and Opinion","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/03007995.2024.2442040","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/20 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 0

Abstract

Background: White coat effect (WCE) is a phenomenon linked to increased cardiovascular risk, where office blood pressure readings exceed home or ambulatory measurements. Excess weight and elevated blood pressure or glucose are associated with WCE in type 2 diabetes (T2D). This study compared dapagliflozin and glibenclamide on WCE in T2D patients under equivalent blood pressure and glucose control.

Methods: This post-hoc analysis of the ADDENDA-BHS2 trial enrolled T2D patients with high cardiovascular risk, defined by stable coronary artery disease or subclinical carotid atherosclerosis. This single-center, open-label, randomized trial included 98 participants, randomized to 12 weeks of dapagliflozin or glibenclamide, in addition to metformin. Baseline blood pressure and glucose control were adjusted to maintain equivalence. This analysis focused on 85 participants with pre- and post-treatment 24-h ambulatory blood pressure data.

Results: Despite blood pressure and glucose control, WCE was present in 28% of participants at baseline. Baseline-adjusted change in WCE on systolic BP showed median changes of -8.6 and 1.7 mmHg for dapagliflozin and glibenclamide groups, respectively (p = 0.048). This effect was not observed on diastolic blood pressure.

Conclusion: Dapagliflozin reduces WCE on systolic blood pressure compared to glibenclamide, even under equivalent blood pressure and glucose control.

Clinical trial registration: The trial was registered at the Clinicaltrials.gov (NCT: 02919345).

达格列净降低2型糖尿病患者收缩压的白大衣效应:ADDENDA-BHS 2试验的事后分析
背景:白大衣效应(WCE)是一种与心血管风险增加有关的现象,办公室血压读数超过家庭或门诊测量值。体重过重、血压或血糖升高与2型糖尿病(T2D)的WCE有关。本研究比较了达格列净和格列本脲在同等血压和血糖控制下对t2dm患者WCE的影响。方法:这项ADDENDA-BHS2试验的事后分析纳入了具有高心血管风险的T2D患者,其定义为稳定冠状动脉疾病或亚临床颈动脉粥样硬化。这项单中心、开放标签、随机试验包括98名参与者,随机分配到12周的达格列净或格列本脲,以及二甲双胍。调整基线血压和血糖控制以保持等值。这项分析集中在85名参与者的治疗前和治疗后24小时动态血压数据。结果:尽管血压和血糖得到了控制,但28%的参与者在基线时出现了WCE。经基线调整的WCE对收缩压的变化显示,达格列净组和格列本脲组的中位变化分别为-8.6和1.7 mmHg (p = 0.048)。对舒张压没有观察到这种影响。结论:与格列本脲相比,达格列净降低了收缩压的WCE,即使在相同的血压和血糖控制下也是如此。临床试验注册:该试验已在Clinicaltrials.gov注册(NCT: 02919345)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Current Medical Research and Opinion
Current Medical Research and Opinion 医学-医学:内科
CiteScore
4.40
自引率
4.30%
发文量
247
审稿时长
3-8 weeks
期刊介绍: Current Medical Research and Opinion is a MEDLINE-indexed, peer-reviewed, international journal for the rapid publication of original research on new and existing drugs and therapies, Phase II-IV studies, and post-marketing investigations. Equivalence, safety and efficacy/effectiveness studies are especially encouraged. Preclinical, Phase I, pharmacoeconomic, outcomes and quality of life studies may also be considered if there is clear clinical relevance
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信