Will Jardiance (Empagliflozin) lower blood pressure (BP)?

From the Guidelines

Jardiance (empagliflozin) can lower blood pressure as a secondary effect, with most patients experiencing a modest reduction in blood pressure of approximately 3-5 mmHg systolic and 1-2 mmHg diastolic, as supported by the EMPA-REG OUTCOME trial 1. This blood pressure-lowering effect occurs because Jardiance works by increasing glucose excretion through the kidneys, which leads to increased sodium excretion and mild diuretic effects. The medication also improves blood vessel function and reduces arterial stiffness. Some key points to consider when using Jardiance for blood pressure management include:

• The medication is primarily prescribed for type 2 diabetes and heart failure, not solely for blood pressure management
• Jardiance has been shown to reduce the risk of cardiovascular disease in high-risk people with type 2 diabetes mellitus, as demonstrated in the EMPA-REG OUTCOME trial 1
• The blood pressure reduction from Jardiance would be considered a beneficial additional effect rather than its primary purpose
• Always consult with your healthcare provider about managing your blood pressure, as they can determine the most appropriate treatment plan for your specific health needs. It's also important to note that Jardiance has been associated with an increased risk of acute kidney injury, dehydration, and orthostatic hypotension, so caution should be taken when using this medication, especially in combination with diuretics and/or ACE inhibitors and angiotensin receptor blockers, as mentioned in the management of hyperglycemia in type 2 diabetes consensus report 1.

From the FDA Drug Label

At Week 24, the systolic blood pressure was statistically significantly reduced compared to placebo by -2.6 mmHg (placebo-adjusted, p-value=0.0231) in patients randomized to 10 mg of JARDIANCE and by -3.4 mmHg (placebo-corrected, p-value=0.0028) in patients randomized to 25 mg of JARDIANCE. At Week 24, the systolic blood pressure was statistically significantly reduced compared to placebo by -4.1 mmHg (placebo-corrected, p-value <0.0001) for JARDIANCE 10 mg and -4.8 mmHg (placebo-corrected, p-value <0.0001) for JARDIANCE 25 mg.

Jardiance may lower blood pressure. The studies showed a statistically significant reduction in systolic blood pressure compared to placebo at Week 24, with reductions ranging from -2.6 mmHg to -4.8 mmHg depending on the dose and study population 2.

• The reductions in blood pressure were observed in patients with type 2 diabetes who were treated with JARDIANCE 10 mg or 25 mg.
• The exact mechanism by which JARDIANCE lowers blood pressure is not specified in the label, but the observed effect is likely related to its overall therapeutic effect on patients with type 2 diabetes.

From the Research

Effect of Jardiance on Blood Pressure

• Jardiance (empagliflozin) has been shown to have a favourable effect on blood pressure in patients with type 2 diabetes 3, 4, 5, 6.
• Studies have demonstrated that empagliflozin can lower systolic blood pressure by approximately 3-4 mmHg and diastolic blood pressure by approximately 1-2 mmHg 5, 6.
• The blood pressure-lowering effect of empagliflozin is thought to be due to its diuretic effect, which leads to a reduction in blood volume and a subsequent decrease in blood pressure 7.
• Empagliflozin has been shown to be effective in reducing blood pressure in patients with type 2 diabetes and hypertension, with significant reductions in both systolic and diastolic blood pressure observed in clinical trials 6.

Clinical Trials and Studies

• A 12-week clinical trial involving 825 patients with type 2 diabetes and hypertension found that empagliflozin significantly reduced blood pressure, with adjusted mean differences versus placebo in change from baseline in mean 24-h systolic blood pressure of -3.44 mmHg and -4.16 mmHg for the 10 mg and 25 mg doses, respectively 6.
• Another study found that empagliflozin reduced systolic blood pressure by approximately 4 mmHg and diastolic blood pressure by approximately 2 mmHg in patients with type 2 diabetes 5.
• The EMPA-REG OUTCOME trial, which involved 7,020 patients with type 2 diabetes and established cardiovascular disease, found that empagliflozin had a cardioprotective effect, with a significant reduction in cardiovascular mortality observed in the empagliflozin group compared to the placebo group 3, 7.