The Role of SGLT-2 Inhibitors in Cardiovascular and Renal Protection

Abstract

SGLT-2 inhibitors have revolutionized the management of chronic diseases, demonstrating profound cardiovascular and renal protective effects that extend beyond their original purpose of glucose-lowering in T2DM. These agents target fundamental pathophysiological mechanisms, including hemodynamic regulation, metabolic efficiency, inflammation, and oxidative stress, making them effective across diverse populations. Landmark clinical trials such as EMPA-REG OUTCOME, CANVAS, DAPA-HF, and DAPA-CKD have shown significant reductions in cardiovascular death, heart failure hospitalizations, and the progression of CKD, even in non-diabetic patients. While generally well-tolerated, SGLT-2 inhibitors require careful patient selection to mitigate risks such as euglycemic diabetic ketoacidosis and volume depletion. Their broad applicability underscores their role as a cornerstone therapy, redefining integrated care for heart failure, CKD, and related conditions. As research expands, SGLT-2 inhibitors promise to further transform chronic disease management, offering improved outcomes, quality of life, and survival for millions worldwide.