Cardioprotective effect of dapagliflozin on elderly T2DM and hypertension patients with different body mass index
Lü Wenxu
Chen Tong
Ding Wei
Li Zhao
Zhang Xuejuan
Abstract：Objective To investigate the cardioprotective effect of dapagliflozin on elderly type 2 di-abetes mellitus(T2DM)patients with concomitant hypertension with different body mass index(BMI).Methods A total of 338 elderly T2DM patients with concomitant hypertension admitted to our department from January 2021 to January 2023 were recruited and divided into two groups based on their medication regimen:the dapagliflozin group(170 patients)and the control group(168 patients).According to their BMI,the patients of the dapagliflozin group were further as-signed into the normal body mass subgroup(34 cases),overweight subgroup(83 cases),and obese subgroup(53 cases).General clinical data were collected before and in 6 months after treat-ment,including body weight,BMI,FPG,glycosylated hemoglobin(HbA1c),left atrium diameter(LAD),inter-ventricular septum thickness(IVST),left ventricular posterior wall thickness(LVPWT),maximum mitral flow velocity during early diastolic period divided by peak mitral ring velocity during early diastolic period(E/e'),and left ventricular mass index(LVMI)and as-sessed adverse drug reactions as well as the incidence of adverse events during follow-up.Results Compared with before treatment,the levels of FPG,HbA1c,IVST,LVPWT and LVMI were sig-nificantly decreased in both groups after 6 months of treatment(P＜0.05).The dapagliflozin group obtained significantly decreased body mass,BMI,LAD,IVST,LVPWT,E/e'and LVMI levels than the control group(P＜0.01).Kaplan-Meier survival analysis revealed a statistically significant difference in cumulative survival rate of adverse events between the two groups(Plog rank=0.038).Multivariate Cox analysis demonstrated that both dapagliflozin(HR=0.218,95％CI:0.076-0.626,P=0.005)and ACEI/ARB/ARNI(HR=0.364,95％CI:0.143-0.927,P=0.034)were protective factors,while,female(HR=3.881,95％CI:1.241-12.135,P=0.020),duration of hypertension(HR=1.054,95％CI:1.000-1.110,P=0.049),body mass(HR=1.055,95％CI:1.005-1.108,P=0.030),age(HR=1.103,95％CI:1.022-1.190,P=0.012),and LVMI(HR=1.029,95％CI:1.001-1.058,P=0.039)were risk factors for major adverse events among all participants included.Compared with the normal body mass subgroup,the over-weight group had more obvious improvements in △IVST,△LVPWT,△E/e'and △LVMI,and the obese group had significant improvements in △LAD,△IVST,△LVPWT,△E/e'and △LVMI(P＜0.05).The obese subgroup obtained more obvious improvements in △LAD,△IVST,△LVPWT,△E/e'and △LVMI than the overweight subgroup(P＜0.05).Conclusion Dapagliflozin demon-strates a cardioprotective effect at different degrees in elderly T2DM patients with hypertension,irrespective of their BMI.It significantly regulates blood glucose,promotes weight reduction,en-hances ventricular remodeling,and exhibits favorable safety.
Keywords：diabetes mellitustype 2hypertensionbody mass indexdapagliflozin
Publication Date：2024-04-15
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：6( 389-394 )