Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes

Abstract

To the Editor: The EMPA-REG OUTCOME trial (Nov. 26 issue)¹ showed relative-risk reductions of 38% in death from cardiovascular causes, 31% in sudden death, and 35% in hospitalization for heart failure with empagliflozin as compared with placebo. The authors briefly speculate about underlying mechanisms. The difference in blood pressure favoring the empagliflozin groups, averaging 4 mm Hg in systolic pressure and 1.5 mm Hg in diastolic pressure (similar to previous data with sodium–glucose cotransporter 2 [SGLT2] inhibitors) and sustained from the first weeks of the trial to its end, cannot be overlooked.

In patients with type 2 diabetes, blood-pressure reduction . . .