ANGIOTENSIN PROFILES IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES WITH COMBINATION THERAPY OF EMPAGLIFLOZIN AND LINAGLIPTIN VERSUS METFORMIN AND INSULIN GLARGINE

Bosch A, Poglitsch M, Kannenkeril D, Ott C, Pietschner R, Striepe K, Schiffer M, Schmieder R (2022)

Publication Type: Journal article

Publication year: 2022

Journal

Journal of Hypertension Lippincott, Williams & Wilkins

Book Volume: 40

Pages Range: e283-e284

DOI: 10.1097/01.hjh.0000838460.41318.ce

Abstract

OBJECTIVE: The renin-angiotensin system (RAS) plays a key role in the physiological regulation of blood pressure. Patients with type-2-diabetes-mellitus (T2DM) and hypertension are known to have increased RAS activity. However, the precise role of RAS activation after SGLT2-inhibitor therapy is unknown. The classic RAS comprises the ACE-AngII-AT1R-axis (classic-axis) that promotes vasoconstriction. The Angiotensin-converting-enzyme-2-angiotensin-(1-7)-Mas axis (Mas-axis) with its components Angiotensin-(1-7) (Ang-1-7) and Angiotensin-(1-5) (Ang-1-5) is an endogenous negative regulatory pathway of the classic-axis, which can reduce its harmful effects. DESIGN AND METHOD: Angiotensin profiles were determined in 55 patients with hypertension and T2DM from our double blind, randomized, placebo controlled clinical trial "Effects of Empagliflozin+Linagliptin (E+L) vs Metformin+Insulin Glargine (M+I) on Renal and Vascular Changes in Type 2 Diabetes'' (ELMI) at baseline and three months after application of either E+L or M+I. An LC-MS/MS based approach was used to simultaneously quantify individual angiotensin metabolites (Attoquant Diagnostics, Vienna, Austria). RESULTS: In the E+L group medication induced a rise in Ang-I, Ang-(1-7) and a trend to a rise in Ang-II between baseline and treatment, which was not present in the M+I group (table).Comparison between the E+L and M+I group revealed that change between baseline and treatment was significantly different for Ang I (p = 0.002) and Ang-(1-7) (p = 0.002) between the groups. No difference in change between baseline and treatment was found for Ang II (p = 0.182) and Ang-(1-5) (p = 0.224) between the E+L and M+I group. CONCLUSIONS: In patients with hypertension and T2DM three months of therapy with E+L led to a rise of classic and protective components of the RAS, which was not present in the M+I group. The biological consequence of this complex RAS activation remains to be elucidated.

Authors with CRIS profile

Agnes Bosch Department of Medicine 4 – Nephrology and Hypertension Christian Ott Department of Medicine 4 – Nephrology and Hypertension Robert Pietschner Department of Medicine 4 – Nephrology and Hypertension Kristina Striepe Professur für Innere Medizin (Nephrologie) Mario Schiffer Lehrstuhl für Innere Medizin IV Roland Schmieder Professur für Innere Medizin (Nephrologie)

Involved external institutions

Attoquant Diagnostics GmbH DE Germany (DE)

How to cite

APA:

Bosch, A., Poglitsch, M., Kannenkeril, D., Ott, C., Pietschner, R., Striepe, K.,... Schmieder, R. (2022). ANGIOTENSIN PROFILES IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES WITH COMBINATION THERAPY OF EMPAGLIFLOZIN AND LINAGLIPTIN VERSUS METFORMIN AND INSULIN GLARGINE. Journal of Hypertension, 40, e283-e284. https://doi.org/10.1097/01.hjh.0000838460.41318.ce

MLA:

Bosch, Agnes, et al. "ANGIOTENSIN PROFILES IN PATIENTS WITH HYPERTENSION AND TYPE 2 DIABETES WITH COMBINATION THERAPY OF EMPAGLIFLOZIN AND LINAGLIPTIN VERSUS METFORMIN AND INSULIN GLARGINE." Journal of Hypertension 40 (2022): e283-e284.

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