Functional and Clinical Importance of SGLT2-inhibitors in Frailty: From the Kidney to the Heart

Hypertension. 2023 Sep;80(9):1800-1809. doi: 10.1161/HYPERTENSIONAHA.123.20598. Epub 2023 Jul 5.

Abstract

SGLT2 (sodium-glucose cotransporter 2) enables glucose and sodium reabsorption in the kidney. SGLT2-inhibitors (also known as gliflozins, which include canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin) act by increasing glycosuria, thereby reducing glycemia. These drugs are critical to reach and keep glycemic control, a crucial feature, especially in patients with comorbidities, like frail individuals. Several studies evaluated the effects of SGLT2-inhibitors in different settings beyond diabetes, revealing that they are actually pleiotropic drugs. We recently evidenced the favorable effects of SGLT2-inhibition on physical and cognitive impairment in frail older adults with diabetes and hypertension. In the present overview, we summarize the latest clinical and preclinical studies exploring the main effects of SGLT2-inhibitors on kidney and heart, emphasizing their potential beneficial actions in frailty.

Keywords: cardiology; endocrinology; frailty; geriatrics; metabolism; nephrology; pharmacology.

Publication types

  • Review
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Benzhydryl Compounds / pharmacology
  • Benzhydryl Compounds / therapeutic use
  • Clinical Relevance
  • Diabetes Mellitus, Type 2*
  • Frailty*
  • Glucose
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Kidney
  • Sodium
  • Sodium-Glucose Transporter 2 / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors* / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use

Substances

  • Sodium-Glucose Transporter 2 Inhibitors
  • Hypoglycemic Agents
  • Sodium-Glucose Transporter 2
  • Glucose
  • Benzhydryl Compounds
  • Sodium