Most Accessed Article – Renoprotective Effects of SGLT2 Inhibitors: Beyond Glucose Reabsorption Inhibition – Current Vascular Pharmacology

Journal: Current Vascular Pharmacology

Author(s): V. Tsimihodimos, T.D. Filippatos, S. Filippas-Ntekouan, M. Elisaf.

Graphical Abstract:


Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a new class of antidiabetic drugs that inhibit glucose and sodium reabsorption at proximal tubules. These drugs may exhibit renoprotective properties, since they prevent the deterioration of the glomerular filtration rate and reduce the degree of albuminuria in patients with diabetes-associated kidney disease. In this review we consider the pathophysiologic mechanisms that have been recently implicated in the renoprotective properties of SGLT2 inhibitors. The beneficial effects of SGLT2 inhibitors on the conventional risk factors for kidney disease (such as blood pressure, hyperglycaemia, body weight and serum uric acid levels) may explain, at least in part, the observed renal-protecting properties of these compounds. However, it has been hypothesized that the most important mechanisms for this phenomenon include the reduction in the intraglomerular pressure, the changes in the local and systemic degree of activation of the renin-aldosterone-angiotensin system and a shift in renal fuel consumption towards more efficient energy substrates such as ketone bodies. The beneficial effects of SGLT2 inhibitors on various aspects of renal function make them an attractive choice in patients with (and possibly without) diabetes-associated renal impairment.

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Upcoming Thematic Issue – Pre and Postconditioning in Cardiac Surgery – Current Vascular Pharmacology

Cvp-THEMATIC FLYER -Jose Luis Guerrero

New Issue :: Current Vascular Pharmacology 15, Issue 3

Current Vascular Pharmacology publishes clinical and research-based reviews, original research articles, letters, debates, drug clinical trial studies and guest edited issues to update all those concerned with the treatment of vascular disease, bridging the gap between clinical practice and ongoing research.

Vascular disease is the commonest cause of death in Westernized countries and its incidence is on the increase in developing countries. It follows that considerable research is directed at establishing effective treatment for acute vascular events. Long-term treatment has also received considerable attention (e.g. for symptomatic relief). Furthermore, effective prevention, whether primary or secondary, is backed by the findings of several landmark trials. Vascular disease is a complex field with primary care physicians and nurse practitioners as well as several specialties involved. The latter include cardiology, vascular and cardio thoracic surgery, general medicine, radiology, clinical pharmacology and neurology (stroke units).


Articles from the journal Current Vascular Pharmacology 15, Issue 3:

For details on the articles, please visit this link ::

Testimonial by Nikolaos Louvis!

Jan Aaseth

Contributed Article: Renoprotection by Direct Renin Inhibition: A Systematic Review and Meta- Analysis

Highlighted Article Flyer for the journal “Current Vascular Pharmacology”

CVP-Articles_15-6- Zhong-min Liu 

Article by Disease – “Efficacy and Safety Assessment of Hypertension Management with Coveram (Perindopril/Amlodipine Fixed Combination) in Patients with Previous Angiotensin Receptor Blocker (ARB) Treatment: Arabian Gulf STRONG Study”

Article by Disease on “Cardiology


Objective: We evaluated the safety and efficacy of hypertension management with Coveram (perindopril/amlodipine combination) in patients with uncontrolled blood pressure (BP). All patients were on previous angiotensin receptor blocker (ARB) treatment.

Methods: This was a 3 country, multi-centre (7 cities), open-label, observational study in the Arabian Gulf. Patients (18 years) were recruited between October 2012 and November 2013 and followed-up for 3 months after enrolment. Outcomes included changes in BP from baseline and BP goal attainment rates as per Joint National Committee- 8 (<140/90 mmHg for diabetics and those <60 years of age and <150/90 mmHg for those 60 years of age without diabetes). Medication tolerance was also assessed from both patient and physician perspectives.

Results: Hypertensive patients (n=760; mean age: 51±10 years; 67% were males) were included. A total of 178 patients (23%) were lost to follow-up. The perindopril/amlodipine combination was associated with an overall reduction in systolic BP (SBP) (31 mmHg; p<0.001) and diastolic BP (DBP) (18 mmHg; p<0.001) from baseline. An overall BP control rate was achieved in 87% (n=507) of the participants. There were significant incremental BP reductions with dose up-titration, especially SBP (p<0.001). Those with high SBP (>180 mmHg) at baseline were associated with a mean reduction of 59 mmHg (p<0.001). The perindopril/amlodipine combination had excellent tolerance levels over the study period from both patient and physician perspectives (at 99% and 98%, respectively; p<0.001).

Conclusions: The perindopril/amlodipine combination is an effective and well tolerated anti-hypertensive option in patients on previous ARB treatment.

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Highlighted Article Flyer for the journal “Current Vascular Pharmacology”

CVP-Articles_15-6-Ayman El-Menyar

Wishing A Very Happy Birthday To Dr. Dimitri P. Mikhailidis!

Dr. Dimitri P. Mikhailidis

Dr. Dimitri P. Mikhailidis

Editor-in-Chief: Current Vascular Pharmacology
Academic Head, Department of Clinical Biochemistry,
Royal Free Hospital Campus,
University College London Medical School,
University College London (UCL),
Pond Street,
London, NW3 2QG,


Upcoming Thematic Issue – Clopidogrel Hypersensitivity: Clinical Aspects and Management Options


Press Release for EurekAlert! Renoprotective effects of sglt2 inhibitors: Beyond glucose reabsorption inhibition

The clinical use of sodium glucose co-transporter 2 inhibitors (SGLT2) represents a recent advance in the treatment of diabetes. Accumulating evidence suggests that these drugs may reduce the risk for the development of diabetic nephropathy or reduce the rate of its progression in patients already suffering from this devastating complication. In this manuscript we summarize the available data on the mechanisms that underlie the renoprotective properties of SGLT2 inhibitors. Apart from their beneficial effects on carbohydrate and uric acid metabolism and their blood pressure-lowering properties, the most important mechanism that can explain the reduction in albuminuria and the preservation of renal function that follows their administration is the reduction in intraglomerular pressure. By increasing sodium delivery to the distal parts of the renal tubules, SGLT2 inhibition results in the vasoconstriction of the afferent arteriole thus reducing the intraglomerular pressure and the hyperfiltration that characterizes the early phases of diabetic nephropathy. In addition, the effect of SGLT-2 inhibitors on the renal and the systematic renin-angiotensin axis may also contribute to the observed renoprotection. More specifically, these drugs inhibit the renal renin-angiotensin axis due to increased delivery of sodium to the macula densa. Although the action of renin-angiotensin axis systematically increases, the concomitant use of drugs that modify the function of this system (angiotensin converting enzyme inhibitors and angiotensin receptor II antagonists), that is common in diabetic patients, results in the activation of type I angiotensin receptors that exhibits vasodilative, antiproliferative, antihypertrophic, and antinflammatory actions. Finally, it has been proposed that the reduction in the energy consumption in the proximal tubular cells as well as the shift in energy substrate utilization from glucose to ketone bodies may also increase the viability of renal tissues. In conclusion, SGLT2 inhibitors may represent the drugs of choice for the treatment and the prevention of diabetic nephropathy.

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