Cardiorenal protective effects of dapagliflozin combined with valsartan in patients with type 2 diabetes mellitus and hypertension: a retrospective cohort study.

BACKGROUND

Hypertension and Type 2 Diabetes Mellitus (T2DM) interact to increase cardiorenal risk. This study evaluated the cardiorenal efficacy of dapagliflozin combined with valsartan in patients with coexisting T2DM and hypertension.

METHODS

This retrospective cohort study included 245 patients admitted between January 2023 and December 2024. Propensity score matching yielded 102 patients in the Monotherapy Group (valsartan 80 mg/day) and 102 in the Combination Group (valsartan 80 mg/day + dapagliflozin 10 mg/day). Outcomes assessed at baseline and 24 weeks included blood pressure, glycemic parameters (FPG, 2hPG, GluCV, PGE, LAGE, MAGE), inflammatory and cardiac biomarkers (hs-CRP, TNF-α, IL-6, IL-33, sST2, sICAM-1), echocardiographic measures (LVEF, LVEDD, LVESD, LAD, IVSd), NT-proBNP, renal function (eGFR, UACR, SCr, BUN), and fibrosis markers (PIIINP, C-IV, LN, TGF-β1).

RESULTS

At 24 weeks, the Combination Group showed greater reductions in systolic (134.86 ± 6.37 vs. 139.68 ± 6.82 mmHg) and diastolic blood pressure (83.12 ± 4.58 vs. 86.29 ± 4.79 mmHg), FPG (6.79 ± 1.02 vs. 7.58 ± 1.10 mmol/L), 2hPG (9.71 ± 1.68 vs. 11.24 ± 1.84 mmol/L), and glycemic variability indices (all P < 0.001). Inflammatory and cardiac biomarkers declined more markedly (P < 0.05). Significant improvements were also observed in LVEF (60.12 ± 4.68% vs. 56.75 ± 4.96%), NT-proBNP, eGFR, UACR, and fibrosis markers (all P < 0.05). Multivariate analysis showed combination therapy independently predicted better outcomes (OR = 2.417, 95% CI: 1.315-4.443, P = 0.004).

CONCLUSION

The addition of dapagliflozin to valsartan was associated with superior cardiorenal outcomes compared to valsartan monotherapy in patients with T2DM and hypertension, as evidenced by enhanced improvements in blood pressure, glycemic control, inflammation, cardiac function, and renal parameters.