IMR Press / RCM / Volume 23 / Issue 12 / DOI: 10.31083/j.rcm2312411
Open Access Review
Addressing Cardiovascular Disparities in Racial/Ethnic Populations: The Blood Pressure-Lowering Effects of SGLT2 Inhibitors
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1 Department of Clinical Research & Leadership, School of Medicine and Health Sciences, The George Washington University, Washington, DC 20052, USA
2 Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112, USA
*Correspondence: kferdina@tulane.edu (Keith C. Ferdinand)
Academic Editor: Giuseppe Boriani
Rev. Cardiovasc. Med. 2022, 23(12), 411; https://doi.org/10.31083/j.rcm2312411
Submitted: 24 September 2022 | Revised: 16 November 2022 | Accepted: 24 November 2022 | Published: 19 December 2022
(This article belongs to the Special Issue SGLT2 Inhibition: New Insight in Cardiology)
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

The racial/ethnic disparities in cardiometabolic risk factors and cardiovascular diseases (CVD) are prominent in non-Hispanic Black adults and other United States (U.S.) sub-populations, with evidence of differential access and quality of health care. High blood pressure (BP) is the most potent and prevalent risk factor for adverse cardiovascular (CV) outcomes across all populations globally, but especially in the non-Hispanic Black adults in the U.S. The use of sodium-glucose cotransporter-2 inhibitors (SGLT2is) demonstrate favorable effects in patients with and without type 2 diabetes (T2DM) in CVD especially for heart failure (HF), as the contemporary clinical practice recommendations and standards of care advocate. The beneficial effects of SGLT2is have been most profoundly documented with HF, including reduced (HFrEF) or preserved ejection fraction (HFpEF), and chronic kidney disease (CKD) with T2DM. Given that hypertension (HTN), CVD, HF, and CKD are significantly greater in certain racial/ethnic populations, the potential impact of SGLT2is will be more significant on the excess cardiometabolic and renal disease, especially in the Black patients. Moreover, there is a need for increased diverse representation in clinical trials. Inclusion of larger members of various racial/ethnic populations may assure that new and emerging data accurately reflect the diversity of the U.S. population. This review highlights potential benefits of SGLT2is, as noted in the most recent literature, and their BP-lowering impact on potentially reducing CV disparities, especially in Black adults. Furthermore, this commentary emphasizes the need to increase diversity in clinical trials to reduce the disparity gaps.

Keywords
SGLT2 inhibitors
hypertension
race/ethnicity
non-Hispanic Black patients
disparities
social determinants
blood pressure
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