High Blood Pressure & Cardiovascular Prevention

, Volume 25, Issue 4, pp 417–420 | Cite as

Lowering Blood Pressure with the Combination of a Sodium-Glucose Cotransporter 2 Inhibitor and a Glucagon-like Peptide-1 Receptor Agonist in Type 2 Diabetic Patients: A Clinical Evidence

  • José Carlos Arévalo-LoridoEmail author
  • Juana Carretero Gómez
  • Ricardo Gómez Huelgas
  • Dolores García de Lucas
  • Lourdes Mateos Polo
  • José Manuel Varela Aguilar
  • Javier Ena Muñoz
Short Communication



Patients with type 2 diabetes mellitus (T2DM) often have numerous cardiovascular risk factors, among which hypertension.


To evaluate the blood pressure variations among patients treated with a combination of a sodium-glucose cotransporter 2 inhibitor (iSGLT-2) and a glucagon-like peptide-1 receptor agonist (GLP-1ra).


We analyze 17 patients treated with this combination to quantify the changes on blood pressure by ambulatory blood pressure monitoring at baseline and at three and 6 months follow-up.


We observed a decrease of HbA1c levels (p = 0.004) at six months follow-up, a decrease in mean 24 h systolic blood pressure [from 124 (11) mmHg to 123 (4.75) mmHg, p = 0.04] and in both, mean waking and sleeping systolic blood pressure, being greater the reduction in the sleeping time [118 (20) mmHg to 111 (20) mmHg, p = 0.004].


The effect of a combination therapy of an iSGLT-2 and a GLP-1ra on blood pressure in a real-world setting, may have summative effects especially in SBP.


Ambulatory blood pressure monitoring Diabetes Glucagon-like peptide-1 receptor agonist Sodium-glucose cotransporter 2 inhibitor 


Compliance with Ethical Standards

Conflict of interest

The authors declare not having conflict of interest. Boehringer Ingelheim, ASTRA and JANSSEN laboratories supported the online database of this registry.

Ethical standards

The study has been approved by the appropriate institutional and/or national research ethics committee (Hospital Universitario de Málaga) and has been performed in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Matheus AS, Tannus LR, Cobas RA, Palma CC, Negrato CA, Gomes MB. Impact of diabetes on cardiovascular disease: an update. Int J Hypertens. 2013;2013:653789.CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Kiselev AR, Posnenkova OM, Belova OA, Romanchuk SV, Popova YV, Prokhorov MD, et al. Impact of clinical factors on the achievement of target blood pressure in hypertensive patients from Ivanovo region of Russia: data of 2015. High Blood Press Cardiovasc Prev. 2017;24:425–35.CrossRefPubMedGoogle Scholar
  3. 3.
    Tikkanen I, Narko K, Zeller C, Green A, Salsali A, Broedl UC, et al. Empagliflozin reduces blood pressure in patients with type 2 diabetes and hypertension. Diabetes Care. 2015;38:420–8.CrossRefPubMedGoogle Scholar
  4. 4.
    Heerspink HJ, de Zeeuw D, Wie L, Leslie B, List J. Dapagliflozin a glucose-regulating drug with diuretic properties in subjects with type 2 diabetes. Diabetes Obes Metab. 2013;15:853–62.CrossRefPubMedCentralGoogle Scholar
  5. 5.
    Townsend RR, Machin I, Ren J, Trujillo A, Kawaguchi M, Vijapurkar U, et al. Reductions in Mean 24-Hour Ambulatory Blood Pressure after 6-week treatment with canagliflozin in patients with type 2 diabetes mellitus and hypertension. J Clin Hypertens (Greenwich). 2016;18:43–52.CrossRefGoogle Scholar
  6. 6.
    Fonseca VA, Deuries JH, Henry RR, Donsmark M, Thomsen HF, Plutzky J. Reduction in systolic blood pressure with Liraglutide in patients with type 2 diabetes: insights from a patient-level pooled analysis of six randomized clinical trials. J Diabetes Complications. 2014;28:399–405.CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Kumarathurai P, Anholm C, Fabricius-Bjerre A, Nielsen OW, Kristiansen O, Madsbad S, et al. Effects of the glucagon-like peptide-1 receptor agonist liraglutide on 24-h ambulatory blood pressure in patients with type 2 diabetes and stable coronary artery disease: a randomized double-blind, placebo-controlled, crossover study. J Hypertens. 2017;35:1070–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Ferdinand KC, White WB, Calhon DA, Lonn EM, Sajer PT, Brunelle R, et al. Effects of the once-weekly glucagon-like peptide-1 receptor agonist dulaglutide on ambulatory blood pressure and heart rate in patients with type 2 diabetes mellitus. Hypertension. 2014;64:731–7.CrossRefPubMedGoogle Scholar
  9. 9.
    Lundkvist P, Pereira MJ, Katsogiannos P, Sjostrom CD, Johnsson E, Eriksson JW. Dapagliflozin once daily plus exenatide once weekly in obese adults without diabetes: sustained reductions in body weight, glycaemia and blood pressure over 1 year. Diabetes Obes Metab. 2017;19:1276–88.CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Ludvik B, Frias JP, Tinahones FJ, Wainstein J, Jiang H, Robertson KE, et al. Dulaglutide as add-on therapy to SGLT2 inhibitors in patients with inadequately controlled type 2 diabetes (AWARD-10): a 24-week, randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol. 2018;6:370–81.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2018

Authors and Affiliations

  • José Carlos Arévalo-Lorido
    • 1
    Email author
  • Juana Carretero Gómez
    • 1
  • Ricardo Gómez Huelgas
    • 2
  • Dolores García de Lucas
    • 3
  • Lourdes Mateos Polo
    • 4
  • José Manuel Varela Aguilar
    • 5
  • Javier Ena Muñoz
    • 6
  1. 1.Internal Medicine DepartmentZafra County HospitalZafraSpain
  2. 2.Internal Medicine DepartmentUniversity Hospital of MálagaMálagaSpain
  3. 3.Internal Medicine Department“Costa del sol” HospitalMarbellaSpain
  4. 4.Internal Medicine DepartmentUniversity Hospital of SalamancaSalamancaSpain
  5. 5.Internal Medicine DepartmentUniversity Hospital “Virgen del Rocio”SevillaSpain
  6. 6.Internal Medicine Department“Marina Baixa” HospitalLa Vila JoiosaSpain

Personalised recommendations