Abstract
Objective To evaluate the efficacy and safety of sodium-glucose cotransporter 2 inhibitors(SGLT2i)in patients with type 2 diabetes mellitus(T2DM)and hypertension(HBP).Methods Randomized controlled trials(RCTs)of SGLT-2 inhibitors in the treatment of patients with type 2 diabetes mellitus complicated with hypertension published up to April 30,2025 were searched through PubMed,Embase,Cochrane Library,Web of Science,CNKI,Wanfang,and VIP databases.Document screening,informa-tion extraction and literature quality evaluation were respectively done by two researchers through inclusion and exclusion criteria,and RevMan 5.3 software for data analysis.The primary outcome indicators were 24-hour ambulatory systolic blood pressure(SBP),24-hour ambulatory diastolic blood pressure(DBP),office-seated SBP,office-seated DBP,and adverse reactions such as hypoglycaemia,urinary tract infection,genital infection,and hypovolaemia.Results A total of 10 RCTs were included.The results showed that com-pared with placebo group,the SGLT2i group significantly reduced 24-hour ambulatory systolic blood pressure(WMD=-4.78,95%CI:-6.31～-3.25,P<0.000 01)and 24-hour ambulatory diastolic blood pressure(WMD=-2.57,95%CI:-3.85～-1.29,P<0.000 01).However,high levels of heterogeneity were observed in both analyses(SBP,I2=85%;DBP,I2=94%).Sensitivity analyses after excluding specific studies reduced heterogeneity,but still had a statistically significant reduction in blood pressure(P<0.000 01).At the same time,office-seated SBP levels in patients with T2DM and hypertension were significantly reduced in the SGLT2i group compared with placebo group(WMD=-4.98,95%CI:-6.64～-3.32,P<0.000 01).In addition,SGLT-2 inhibitors in combination with conventional antihypertensive regimens were associated with an increased risk of hypoglycaemia(RR=1.85,95%CI:1.09～3.13,P<0.05)and genital infections(RR=2.48,95%CI:1.26～4.87,P<0.05);there was no statistically significant difference in the incidence of hypovolaemia(RR=1.85,95%CI:1.09～3.13,P<0.05)and urinary tract infection(RR=1.74,95%CI:0.9～3.39,P>0.05)compared with conventional antihypertensive combined with placebo.Conclusions SGLT2i can reduce 24-hour ambulatory blood pressure and more significant systolic blood pressure in patients with T2DM and HBP,with more significant re-duction in systolic blood pressure,but it is necessary to pay attention to the risk of hypoglycaemia and genital infection.For patients with hypertension and type 2 diabetes,SGLT2i can be an effective antihypertensive treatment option in addition to standard therapy.关键词
钠葡萄糖协同转运蛋白2抑制剂/高血压/2型糖尿病/安全性/有效性Key words
sodium-glucose cotransporter 2 inhibitor/hypertension/type 2 diabetes mellitus/safety/efficacy分类
医药卫生
