Novel oral hypoglycemic agents SGLT-2 inhibitors: cardiovascular benefits and potential mechanisms

Diabetes is an independent risk factor for cardiovascular events, and cardiovascular diseases (CVD) increase the risk of death when combined with diabetes. Diabetes and coronary heart disease are like two sides of a coin, which increase each other's long-term cardiovascular events. Therefore, a glucose-lowering regimen that can change the cardiovascular outcome has become a hot spot in the cardiovascular field in recent years. SGLT-2 (sodium-glucose cotransporter type 2) inhibitors have a novel hypoglycemic mechanism that reduces blood glucose by promoting glucose excretion. Clinical studies have shown that SGLT-2 inhibitors such as dapagliflozin and empagliflozin can reduce major cardiovascular adverse events, CV mortality, all-cause mortality, and hospitalization for heart failure. The pharmacological mechanisms by which SGLT-2 inhibitors achieve cardiovascular benefits have also become hot spots. Possible mechanisms for the cardiovascular benefits of SGLT-2 inhibitors known so far include lowering blood pressure, improving heart function and atherosclerosis, reducing inflammation and oxidative stress. This review discusses the clinical trials and possible pharmacological mechanisms of cardiovascular benefits of SGLT2 inhibitors.