| Background and objective:Hypertension is the most important risk factor of cardiovascular disease(CVD),and the diabetes is coronary heart disease(CHD)risk equivalents,both of which are closely linked to the occurrence of cardiovascular and cerebrovascular diseases.Diabetic patients complicated with hypertension generally have 2 times higher CVD risk than that in patients with only one of these conditions,and the stroke risk of diabetic and hypertensive patients was 10.92 times higher than type 2 diabetes mellitus(T2DM)patients[1].In addition,the incidence of major cardiovascular events in hypertensive patients with diabetes would increase four times[2]Hence,the reasonable control on hypertension and diabetes is of great significance to effectively reduce the incidence of cardiovascular disease(CVD).Unfortunately,hypoglycemic drugs have not been proved to reduce CVD risk in diabetic patients in previous studies,while recent studies have confirmed that sodium-glucose co-transporter 2 inhibitors(SGLT-2i)can decrease the incidence of adverse cardiovascular(CV)events and improve prognosis of patients with diabetes mellitus[3].However,for hypertensive patients with diabetes,the potential effect and underlying mechanism of SGLT-2i are rarely reported[4].Thus,this study was intended to explore the detailed role and mechanism of daglitazine in patients with hypertension complicated with diabetes mellitus via the research of changes in cardiovascular risk factors(CVRF)Materials and methods:A total of 75 patients(39 males and 36 females)meeting the inclusion criteria treated in our hospital from October 2018 to May 2019 were selected as the objects for this study.The patients enrolled were randomly divided into the research group(n=39)and control group(n=36),with the age ranging from 40 to 70 years old(average:57.56±7.8 years old).All patients received the routine treatment.Afterwards,the research group was treated with 10mg/day dapagliflozin,while the control group was given the placebo and hypoglycemic drugs with the adjusted dosage.The body weight(BW),body mass index(BMI),waist circumference(WC),systolic blood pressure(SBP),diastolic blood pressure(DBP),pulse pressure(PP)and mean arterial pressure(MAP)in both groups were measured before and after 12 weeks of treatment.Blood samples were taken from patients on an empty stomach for about 10 hours to detect the following data:fasting plasma glucose(FPG),hemoglobin Ale(HbAIC),total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),alpha lipoprotein(aLp),small and dense low density lipoprotein cholesterol(sdLDL-C),homocysteine(Hey),C-reactive protein(CRP),hematocrit,cystatin C(Cysc),uric acid(UA)and 2h postprandial blood glucose(2hPBG).SPSS21.0 software was adopted for statistical analyses.Results:(1)The BW,BMI and WC of the research group after treatment were significantly lower than those before treatment(P<0.05),while there was no significant differences in those data before and after treatment in the control group(P>0.05).Besides,the changes of BW,BMI and WC before and after treatment in the research group were more obvious than those in the control group,and the differences were significant(P<0.05).(2)The levels of FBG,2hPBG and HbAIc in both the research group and the control group after treatment were significantly lower than those before the treatment(P<0.05).Moreover,the changes of FBG,2hPBG and HbA1c in the research group before and after treatment were more obvious than those in the control group with significant differences(P<0.05).(3)The levels of TC,LDL-C,sdLDL-C and Lp(a)in the research group after treatment were lower than those before treatment,but there was no significant difference(P>0.05).After the treatment,HDL-C was increased and TG was decreased compared with that before treatment(P<0.05).As for the control cases,TC,TG,HDL-C,LDL-C,sdLDL-C and Lp(a)were decreased following the treatment without significant difference(P>0.05).The changes of TG and HDL-C in the research group were significantly higher than those in the control group(P<0.05).There was no significant difference in TC,LDL-C,sdLDL-C and Lp(a)between the these two groups(P>0.05).(4)The levels of SBP,DBP,PP,MAP and Hcy in the research group after treatment were significantly lower than those before treatment,and there were significant differences(P<0.05).For the control group,there was no significant difference in the above indexes before and after treatment(P>0.05).The above indexes in the control group after treatment were slightly lower than those before treatment,but there was no significant difference between the two groups(P>0.05).Further,the changes of SBP,DBP,PP,MAP and Hcy in the research group before and after treatment were more obvious than those in the control group(P<0.05).(5)There were significant differences in the decrease of CRP and the increase of hematocrit after treatment in the research group(P<0.05),but not in the control group(P>0.05).The changes between the two groups showed significant differences before and after treatment(P<0.05).Additionally,the changes of CRP and hematocrit in the research group were more obvious than those in the control group before and after treatment(P<0.05).(6)The decreased UA and Cysc were found in the research group after treatment(P<0.05),whereas there was no significant change in the control group(P>0.05).Moreover,there were significant differences in the changes of UA and Cysc between the two groups before and after treatment(P<0.05).In addition,the changes of Cysc and UA in the research group before and after treatment were more obvious than those in the control group(P<0.05).Conclusion:Dapagliflozin can not only reduce blood glucose,but also reduce body weight,blood pressure,uric acid,increase high density lipoprotein,reduce triglyceride and improve lipid metabolism,renal function and anti-inflammation in patients with hypertension complicated with T2DM. |
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