{"id":"e864d66094f5","type":"article","url":"https://hartvaat.nl/2026/02/01/dapagliflozine-bij-cv-risico-met-zonder-diabetes-cardiorenale-effecten/","title":"Dapagliflozine bij CV-risico met/zonder diabetes: cardiorenale effecten","title_en":"Cardiovascular-Kidney Effects of Dapagliflozin in Patients at Cardiovascular Risk With or Without Type 2 Diabetes: Results of a Randomized, Double-Blind, Placebo-Controlled Trial.","category":"preventie","category_label":"Preventie","professions":["cardioloog","internist"],"tags":["dapa-hf","dapagliflozine","diabetes-type-2","fidelio-dkd","figaro-dkd","soul-trial"],"journal":"Hypertension (Dallas, Tex. : 1979)","doi":"10.1161/HYPERTENSIONAHA.125.25955","source_url":"https://doi.org/10.1161/HYPERTENSIONAHA.125.25955","authors":["Vikas S Sridhar","Luxcia Kugathasan","Yuliya Lytvyn","Yangqing Deng","Hongyan Liu","Leif Erik Lovblom","Josephine Tse","Massimo Nardone","John S Floras","Tosin Osuntokun","Tomoyuki Tobushi","Ruthabella C Y Lam","Brian Lam","Jasper Stevens","Dylan Burger","Daan J Touw","Hiddo J L Heerspink","Julie A Lovshin","Bruce A Perkins","David Z I Cherney"],"significance":7,"published":"2026-02-01","source_date":"2026-02-01","image":"","kennis":["https://hartvaat.nl/kennis/preventie/preventie-bij-diabetes/","https://hartvaat.nl/kennis/lipiden/lpa-meten-wanneer-waarom/"],"congress":"","summary_en":"This study demonstrated that dapagliflozin improves vascular stiffness and cardiorenal markers in patients at cardiovascular risk regardless of diabetes status, providing mechanistic support for the universal cardiorenal protective effects of SGLT2 inhibitors.","created":"2026-07-03T10:32:09Z","updated":"2026-07-03T13:31:07Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie onderzocht de cardiorenale effecten van dapagliflozine bij patiënten met CV-risico, ongeacht diabetes. Het voordeel was consistent, wat SGLT2-remmers als universele cardiorenale beschermers bevestigt.","abstract_original":"BACKGROUND: We investigated the impact of 12 weeks of sodium-glucose cotransporter-2 inhibition (dapagliflozin 10 mg daily) on vascular stiffness, cardiac and kidney function, and neurohormonal pathways in participants at cardiovascular risk. METHODS: This randomized double-blind, parallel-group, placebo-controlled study enrolled 51 participants with at least 1 established cardiovascular condition or cardiovascular risk factor. Participants underwent 3 sequential assessments under clamped euglycemia (4-6 mmol/L): at baseline, at 1 week and 12 weeks of treatment. The primary outcome was vascular arterial stiffness, quantified as augmentation index and pulse-wave velocity. Secondary outcomes included: blood pressure, body fluid composition, noninvasive cardiac output monitoring, arterial vasodilatation tests, heart rate variability, echocardiography, iohexol-measured glomerular filtration rate, and natriuresis. RESULTS: Dapagliflozin decreased vascular arterial stiffness, as measured by aortic augmentation index (placebo-adjusted change of -7.4±2.8%, P=0.01) after 12 weeks. Dapagliflozin acutely decreased extracellular fluid (-0.8±0.3 L, P=0.004), with sustained reductions in thoracic fluid content at 12 weeks (-3.3±1.5 kΩ-1, P=0.03). Reductions in measured glomerular filtration rate (-5.8±2.1 mL/min per 1.73m2, P=0.008) were accompanied by acute increases in proximal sodium excretion (5.1±2.2%, P=0.03), absolute fractional distal sodium reabsorption (4.4±2.1%, P=0.04), and urine adenosine (0.21±0.08 mmol/L per μmol Cr, P=0.01). CONCLUSIONS: Dapagliflozin induced early cardiorenal changes in individuals at varying levels of cardiovascular risk in whom evidence of clinical protection is lacking. Clinical trials in lower-risk populations, particularly in the context of primary prevention, are needed to determine whether these effects of sodium-glucose cotransporter-2 inhibition translate into improved clinical cardiorenal outcomes. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT04258371."}