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Purpose of Review <p>Hypertension is the leading modifiable risk factor for cardiovascular disease. Despite multiple antihypertensive therapies, blood pressure (BP) control remains suboptimal in many individuals with persistent cardiovascular risk. This review evaluates the antihypertensive potential of sodium-glucose cotransporter-2 inhibitors (SGLT2-i) and glucagon-like peptide-1 receptor agonists (GLP-1RA), particularly in patients with comorbid diabetes, HF, CKD or resistant hypertension.</p> Recent Findings <p>SGLT2-i consistently lower office SBP/DBP (2.5–4.0/1.5–2.0 mmHg) and 24-hour ambulatory BP (3.8/1.8 mmHg). GLP-1RAs show modest SBP reductions (1.8–5.1 mmHg) and minimal DBP effects (~ 0.5 mmHg), though tirzepatide shows greater efficacy (~ 10.6 mmHg) in select populations. Both classes have demonstrated cardio-renal benefits, favorable safety profiles, and reduced polypharmacy.</p> Summary <p>SGLT2-i exert more consistent BP-lowering effects than GLP-1RA, largely due to their diuretic-like action. While not first-line therapies, both drug classes show promise as adjuncts in high-risk populations. Future research should further define their role in comprehensive hypertension management.</p>

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Blood Pressure-Lowering Effects of SGLT2 Inhibitors and GLP-1 Receptor Agonists

  • 期刊论文

  • 发表日期：

    2025年12月1日

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  • Ahmed Kamal Siddiqi,
  • Muhammad Shahzeb Khan,
  • Anandita Kulkarni,
  • Michael E. Hall,
  • Michael Böhm,
  • Javier Díez,
  • Javed Butler

摘要

Purpose of Review

Hypertension is the leading modifiable risk factor for cardiovascular disease. Despite multiple antihypertensive therapies, blood pressure (BP) control remains suboptimal in many individuals with persistent cardiovascular risk. This review evaluates the antihypertensive potential of sodium-glucose cotransporter-2 inhibitors (SGLT2-i) and glucagon-like peptide-1 receptor agonists (GLP-1RA), particularly in patients with comorbid diabetes, HF, CKD or resistant hypertension.

Recent Findings

SGLT2-i consistently lower office SBP/DBP (2.5–4.0/1.5–2.0 mmHg) and 24-hour ambulatory BP (3.8/1.8 mmHg). GLP-1RAs show modest SBP reductions (1.8–5.1 mmHg) and minimal DBP effects (~ 0.5 mmHg), though tirzepatide shows greater efficacy (~ 10.6 mmHg) in select populations. Both classes have demonstrated cardio-renal benefits, favorable safety profiles, and reduced polypharmacy.

Summary

SGLT2-i exert more consistent BP-lowering effects than GLP-1RA, largely due to their diuretic-like action. While not first-line therapies, both drug classes show promise as adjuncts in high-risk populations. Future research should further define their role in comprehensive hypertension management.