Diabetes Mellitus, Type 2 Clinical Trial
Official title:
A Randomized, Unicenter, Parallel Study of the Effect of Dapagliflozin on Central Blood Pressure Reduction Compared to Glimepiride in Adult Subjects With Type 2 Diabetes Mellitus and Inadequate Glycemic Control.
This superiority of central pressure versus peripheral measures to predict cardiovascular events has also been reported in general population or in elder people
The prognostic value of central systolic/diastolic pressure, central pulse pressure and AI
has been well demonstrated, firstly after CAFÉ study, with 2073 hypertensive subjects
followed up 3.4 years. It also evidenced higher prognostic value of central blood pressure
compared to peripheral blood pressure. One year later, the STRONG study, showed central
pulse pressure to be an independent cardiovascular risk factor as well as higher prognostic
value compared to peripheral pulse pressure (Hazard ratio; 1,1510 mmHg Vs 1,10mmHg; X2:
13,4; p < 0,001). Those subjects with higher central blood pressure and central pulse
pressure showed higher incidence of cardiovascular events. This superiority of central
pressure versus peripheral measures to predict cardiovascular events has also been reported
in general population or in elder people.
Finally, it has been also reported that dapagliflozin modestly reduces systolic blood
pressure in patients with T2DM who were mostly receiving treatment for hypertension. Despite
office blood pressure remains the gold standard method for screening, diagnostic and
treatment of hypertension, it has been also well demonstrated that ambulatory blood pressure
monitoring (ABPM) better estimates cardiovascular risk and target organ damage than office
blood pressure. It still remains unclear the effects on 24 hours blood pressure reduction
with SGLT-2 inhibitors.
The effects of SGLT2 inhibitors on central blood pressure reduction have not been
documented.
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