Jardiance (Empagliflozin) and Blood Pressure Reduction
Yes, Jardiance (empagliflozin) significantly reduces blood pressure in addition to its glucose-lowering effects. The blood pressure-lowering effect is well-documented in clinical trials and is considered one of the important cardiovascular benefits of this medication.
Mechanism and Magnitude of Blood Pressure Reduction
Empagliflozin lowers blood pressure through several mechanisms:
- Diuretic and natriuretic effects - promotes sodium and fluid excretion 1
- Weight reduction - typically 2-3 kg weight loss contributes to BP lowering 1, 2
- Vascular effects - may improve arterial compliance
The magnitude of blood pressure reduction with Jardiance is clinically significant:
- Systolic blood pressure: Decreases by approximately 4-8 mmHg
- Diastolic blood pressure: Decreases by approximately 2-3 mmHg
In clinical trials, these effects were observed:
- In the EMPA-REG OUTCOME trial, empagliflozin reduced systolic blood pressure by 4-5 mmHg compared to placebo 1
- FDA drug labeling data shows systolic blood pressure reductions of 2.6-4.8 mmHg when used alone or with metformin 2
- A 2019 meta-analysis confirmed significant reductions in both systolic and diastolic blood pressure with empagliflozin 3
Blood Pressure Effects in Specific Populations
The blood pressure-lowering effect of empagliflozin has been demonstrated across various populations:
- General type 2 diabetes population: Consistent reductions in both office and ambulatory blood pressure measurements 1
- Black patients with hypertension and diabetes: A dedicated 24-week study showed empagliflozin reduced 24-hour ambulatory systolic BP by 8.4 mmHg compared to placebo, with effects increasing from 12 to 24 weeks 4
- Patients with established cardiovascular disease: Blood pressure reduction contributes to the overall cardiovascular benefit 1
Clinical Implications
The blood pressure-lowering effect of empagliflozin has important clinical implications:
- Cardiovascular risk reduction: Contributes to the 14% reduction in major adverse cardiovascular events seen in the EMPA-REG OUTCOME trial 1
- Heart failure benefit: The 35% reduction in hospitalization for heart failure may be partly attributed to blood pressure and volume effects 1
- Additive effect: Can complement other antihypertensive medications 5
Monitoring and Precautions
When using empagliflozin for its blood pressure-lowering effects:
- Monitor for hypotension: Especially when combined with other antihypertensive medications 1, 5
- Volume depletion risk: Elderly patients and those on diuretics may be at higher risk 2
- Medication adjustments: May need to adjust doses of other antihypertensive medications if blood pressure decreases significantly 5
Timing of Blood Pressure Effect
The blood pressure-lowering effect of empagliflozin:
- Begins within weeks of starting treatment
- May continue to increase over time, with full effect potentially taking up to 6 months 4
- Is sustained with continued treatment
The blood pressure reduction with empagliflozin provides an additional benefit beyond glycemic control for patients with type 2 diabetes, particularly those with hypertension or cardiovascular disease.