Blood Pressure-Lowering Effects of SGLT2 Inhibitors and GLP-1 Receptor Agonists.

IF 6.3 2区医学 Q1 PERIPHERAL VASCULAR DISEASE

Current Hypertension Reports Pub Date : 2025-12-01 DOI:10.1007/s11906-025-01342-7

Ahmed Kamal Siddiqi, Muhammad Shahzeb Khan, Anandita Kulkarni, Michael E Hall, Michael Böhm, Javier Díez, Javed Butler

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Abstract

Purpose of review: Hypertension is the leading modifiable risk factor for cardiovascular disease. Despite multiple antihypertensive therapies, blood pressure (BP) control remains suboptimal in many individuals with persistent cardiovascular risk. This review evaluates the antihypertensive potential of sodium-glucose cotransporter-2 inhibitors (SGLT2-i) and glucagon-like peptide-1 receptor agonists (GLP-1RA), particularly in patients with comorbid diabetes, HF, CKD or resistant hypertension.

Recent findings: SGLT2-i consistently lower office SBP/DBP (2.5-4.0/1.5-2.0 mmHg) and 24-hour ambulatory BP (3.8/1.8 mmHg). GLP-1RAs show modest SBP reductions (1.8-5.1 mmHg) and minimal DBP effects (~ 0.5 mmHg), though tirzepatide shows greater efficacy (~ 10.6 mmHg) in select populations. Both classes have demonstrated cardio-renal benefits, favorable safety profiles, and reduced polypharmacy. SGLT2-i exert more consistent BP-lowering effects than GLP-1RA, largely due to their diuretic-like action. While not first-line therapies, both drug classes show promise as adjuncts in high-risk populations. Future research should further define their role in comprehensive hypertension management.

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SGLT2抑制剂和GLP-1受体激动剂的降血压作用。

综述目的：高血压是心血管疾病的主要可改变危险因素。尽管有多种降压治疗，但在许多持续存在心血管风险的个体中，血压（BP）控制仍然不是最佳的。本综述评估了钠-葡萄糖共转运蛋白-2抑制剂（SGLT2-i）和胰高血糖素样肽-1受体激动剂（GLP-1RA）的降压潜力，特别是在合并糖尿病、HF、CKD或顽固性高血压的患者中。最近发现：SGLT2-i持续降低办公室收缩压/舒张压（2.5-4.0/1.5-2.0 mmHg）和24小时动态血压（3.8/1.8 mmHg）。GLP-1RAs显示适度的收缩压降低（1.8-5.1 mmHg）和最小的舒张效应（~ 0.5 mmHg），尽管替西帕肽在特定人群中显示更大的疗效（~ 10.6 mmHg）。这两种药物对心脏和肾脏都有益处，具有良好的安全性，并且减少了多重用药。SGLT2-i比GLP-1RA具有更一致的降血压作用，主要是由于其利尿剂样作用。虽然不是一线治疗，但这两种药物都有望作为高危人群的辅助药物。未来的研究应进一步明确其在高血压综合治疗中的作用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Hypertension Reports 医学-外周血管病

CiteScore

10.50

自引率

0.00%

发文量

审稿时长

6-12 weeks

期刊介绍： This journal intends to provide clear, insightful, balanced contributions by international experts that review the most important, recently published clinical findings related to the diagnosis, treatment, management, and prevention of hypertension. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as antihypertensive therapies, associated metabolic disorders, and therapeutic trials. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.