# Dapagliflozin verlaagt bloeddruk als add-on bij hypertensie met T2D, CKD of hartfalen

*geplaatst 2026-10-10 · Hypertensie · Clinical and experimental hypertension (New York, N.Y. : 1993) · doi 10.1080/10641963.2026.2731624 · https://hartvaat.nl/2026/12/31/dapagliflozin-verlaagt-bloeddruk-als-add-on-bij-hypertensie-met-t2d-ckd-of-hartf/*

Deze narratieve review analyseert de antihypertensieve werking en onderliggende mechanismen van dapagliflozin bij patiënten met hypertensie in combinatie met type 2-diabetes, chronische nierziekte of hartfalen. De behandeling leidt tot een consistente bloeddrukdaling waarbij de systolische daling groter is dan de diastolische, voornamelijk gedreven door osmotische diurese, natriuresis, gewichtsreductie en verbeterde vasculaire functie. Dapagliflozin toont een acceptabel veiligheidsprofiel, zij het met een verhoogd risico op genitale infecties, en wordt ondersteund als add-on therapie naast conventionele antihypertensiva. De bevindingen onderstrepen de cardiorenale meerwaarde van SGLT2-remmers in de hypertensiezorg, hoewel gerichte hypertensietrials nodig zijn om de exacte klinische positionering verder te definiëren.

## English: Efficacy and mechanistic insights of dapagliflozin in hypertension management.

This narrative review synthesizes clinical evidence and biological mechanisms underlying the blood pressure-lowering effects of dapagliflozin in patients with hypertension and comorbid type 2 diabetes, chronic kidney disease, or heart failure. Treatment consistently reduces systolic blood pressure more than diastolic pressure, driven by osmotic diuresis, natriuresis, weight loss, and improved vascular function, with a manageable safety profile marked by an increased risk of genital infections. Dapagliflozin is supported as an adjunctive therapy rather than a replacement for conventional antihypertensives. These findings reinforce the cardiorenal benefits of SGLT2 inhibitors in hypertension management, though dedicated hypertension-focused trials are needed to further clarify their positioning.

## Abstract (original, from the publication)

Hypertension remains one of the leading modifiable risk factors for cardiovascular disease and premature mortality worldwide. Blood pressure (BP) management is particularly challenging in patients with coexisting type 2 diabetes (T2D), chronic kidney disease (CKD), or heart failure (HF). Sodium-glucose cotransporter 2 (SGLT2) inhibitors have become an integral component of contemporary cardiorenal therapy and have consistently demonstrated additional BP-lowering effects across diverse clinical settings. This narrative review synthesizes the current clinical evidence regarding the antihypertensive effects of dapagliflozin and summarizes the biological mechanisms that may contribute to these effects, including osmotic diuresis and natriuresis, weight reduction, modulation of the sympathetic nervous system, enhanced uric acid excretion, and attenuation of oxidative stress, inflammation, and vascular dysfunction. Across clinical studies, reductions in systolic BP (SBP) generally exceed those in diastolic BP (DBP), although the physiological basis underlying this differential response remains incompletely understood. Dapagliflozin has demonstrated good tolerability and antihypertensive effects in clinical applications, its long-term use may be limited by the risk of genital infections. Collectively, the available evidence supports dapagliflozin as a cardiorenal therapeutic agent that may provide additional BP-lowering benefits in patients with hypertension and concomitant T2D, CKD, or HF, rather than as a substitute for conventional antihypertensive therapy. Future hypertension-focused clinical studies are warranted to further define its role in hypertension management.

Auteurs: Zhongbo Chen, Wang Chunbin, Hanmei Zhang, Ting Luo, Jinhua Yan

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Bron: Clinical and experimental hypertension (New York, N.Y. : 1993), https://doi.org/10.1080/10641963.2026.2731624. Bijgewerkt 2026-10-04T00:46:22Z. 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.