The popular diabetes medication empagliflozin offers additional protection for the heart and blood vessels by reducing systemic vascular inflammation, according to a study by researchers at Vanderbilt University Medical Center.
Published in the medical journal Circulation, the clinical trial demonstrated that the drug alters immune cell behavior and significantly lowers cellular complexes linked to cardiovascular disease within two weeks of treatment.
Scientists monitored 16 women living with obesity and prediabetes who took empagliflozin daily over a period of three months. To isolate the specific biological effects of the medication, the research team simultaneously tracked a separate control group of women following a low-calorie diet.
Researchers evaluated the state of each participant's immune system prior to the trial, after two weeks of treatment, and at the three-month mark. Within just two weeks of starting empagliflozin, tests showed a significant drop in the concentration of monocyte-platelet aggregates in the blood.
Immune cell transformation
Monocyte-platelet aggregates are cellular complexes formed when white blood cells attach to blood-clotting fragments. These complexes promote inflammation within blood vessel walls and are strongly associated with the long-term development of cardiovascular conditions, including coronary artery disease and heart attacks.
After three months of empagliflozin therapy, the reduction in these inflammatory cell aggregates became even more pronounced. Crucially, the control group following a low-calorie diet showed no corresponding decrease in aggregate levels, indicating that the vascular improvements were driven by the medication itself rather than weight loss.
The study also found that empagliflozin actively shifted monocytes from a pro-inflammatory state into a more stable state. Monocytes are key immune cells that can drive vascular damage when overactivated, and stabilizing them helps prevent harmful inflammatory responses inside arterial tissue.
Understanding SGLT2 inhibitors
Empagliflozin belongs to a class of prescription medications known as sodium-glucose cotransporter-2 inhibitors, commonly referred to as SGLT2 inhibitors. Primarily prescribed to manage high blood sugar levels in adults with type 2 diabetes, the medication works by prompting the kidneys to filter excess glucose out of the bloodstream and excrete it through urine.
While medical regulators have previously approved SGLT2 inhibitors for reducing heart failure risks, the precise biological pathways behind their cardiovascular benefits have remained only partially understood. Researchers at Vanderbilt University Medical Center, a major academic health center based in Nashville, Tennessee, believe the newly identified immune mechanism explains a key portion of the protective effect that SGLT2 inhibitors exert on heart tissue and blood vessels.
The findings build on growing research into lifestyle and therapeutic approaches to cardiovascular risk reduction. Separate scientific studies have previously established that dietary adjustments, such as the regular consumption of legumes, can also help lower the overall risk of developing cardiovascular diseases.
