Managing patients with both hypertension and type 2 diabetes mellitus (T2DM) remains challenging because the combination substantially increases cardiovascular and renal risk. A retrospective cohort study, published in Frontiers in Endocrinology, found that adding Dapagliflozin to Valsartan was associated with broader improvement in cardiorenal measures than valsartan alone over 24 weeks.

The analysis included 245 hospitalized patients treated between January 2023 and December 2024. After propensity score matching, 102 patients received valsartan 80 mg/day alone and 102 received valsartan 80 mg/day plus dapagliflozin 10 mg/day. Outcomes assessed at baseline and week 24 included blood pressure, glycemic indices, inflammatory biomarkers, echocardiographic parameters, renal markers, and fibrosis-related biomarkers.

At 24 weeks, the combination group had lower systolic blood pressure (134.86 ± 6.37 vs 139.68 ± 6.82 mmHg) and diastolic blood pressure (83.12 ± 4.58 vs 86.29 ± 4.79 mmHg). Fasting plasma glucose (6.79 ± 1.02 vs 7.58 ± 1.10 mmol/L) and 2-hour postprandial glucose (9.71 ± 1.68 vs 11.24 ± 1.84 mmol/L) were also lower, with greater reductions across glycemic variability measures (all P < 0.001).

The combination group also showed larger improvements in left ventricular ejection fraction (60.12 ± 4.68% vs 56.75 ± 4.96%), N-terminal pro-B-type natriuretic peptide, estimated glomerular filtration rate, urine albumin-to-creatinine ratio, and fibrosis markers (all P < 0.05). Multivariable analysis showed combination therapy was independently associated with better overall outcomes (OR 2.417; 95% CI 1.315-4.443; P = 0.004).

These findings suggest that adding dapagliflozin to valsartan may provide broader short-term cardiorenal improvement than valsartan alone in patients with coexisting T2DM and hypertension.