Real-world opportunity of empagliflozin to improve blood pressure control in African American patients with type 2 diabetes: A National Cardiovascular Data Registry "research-to-practice" project from the diabetes collaborative registry

• Type of Material: Article
• Authors: Suzanne V. Arnold, University of Missouri Kansas City; Leo Seman, Boehringer Ingelheim Pharmaceuticals; Fengming Tang, University of Missouri Kansas City; Poghni A. Peri-okonny, University of Missouri Kansas City; Keith C. Ferdinand, Tulane University; Sanjeev Mehta, Joslin Diabetes Center; Abhinav Goyal, Emory University; Laurence Sperling, Emory University; Mikhail Kosiborod, University of Missouri Kansas City
• Language: English
• Date: 2019-02-01
• Publisher: WILEY
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2018 John Wiley & Sons Ltd
• Final Published Version (URL): http://dx.doi.org/10.1111/dom.13510
• Title of Journal or Parent Work: DIABETES OBESITY & METABOLISM
• Volume: 21
• Issue: 2
• Start Page: 393
• End Page: 396
• Grant/Funding Information: The Diabetes Collaborative Registry is funded by AstraZeneca (founding sponsor) and Boehringer Ingelheim. The co-author from Boehringer Ingelheim reviewed and edited the manuscript for intellectual content; however, the sponsors of the registry had no role in the final review and approval of the manuscript for submission.
• Keywords: hypertension; RISK; Endocrinology & Metabolism; cardiovascular disease; Science & Technology; Life Sciences & Biomedicine; OUTCOMES; HYPERTENSION; diabetes; TRIAL
• Research Categories: Health Sciences, Public Health; Sociology, Demography; Health Sciences, Medicine and Surgery; Health Sciences, Epidemiology

Abstract

The 1245.29 Trial recently showed that empaglifozin improved both blood pressure and glucose control in African American (AA) patients with type 2 diabetes (T2D) and hypertension. Using the Diabetes Collaborative Registry, a large-scale US registry of outpatients with diabetes recruited from primary care, cardiology and endocrinology practices, we sought to understand the potential impact of these observations in routine clinical practice. Among 74 290 AA patients with T2D from 368 US clinics, 60.4% had hypertension, of whom 34.5% had systolic blood pressure ≥ 140 mm Hg (20.8% of the total AA T2D population). Only 1.7% of this eligible population had been prescribed a sodium-glucose co-transporter two inhibitor. The mean estimated 5-year risk of cardiovascular death was 7.7%, which could be reduced to 6.2% when modelling the antihypertensive effect of empagliflozin across the eligible population (based on an 8-mm Hg blood pressure reduction). These findings may represent a potential opportunity for better management of cardiovascular risk factors and improved outcomes in this vulnerable cohort.