Heart failure is one of the most common heart diseases affecting more than 30 million people worldwide. It happens when the heart cannot supply enough blood and oxygen to meet the demands of the body’s essential organs.
There are two types of heart failure. About half of the patients have a type called reduced ejection fraction, where the heart does not pump properly. The other half of heart failure patients have a type called conserved ejection fraction. This is where the heart still seems to pump well, but it can not relax properly between each heartbeat – meaning it is still unable to meet the body’s oxygen needs. This type is more difficult to diagnose as it appears to pump normally during an ultrasound – therefore it requires additional tests to diagnose.
Typically, patients with the first type of heart failure receive medication that can improve the symptoms and reduce the risk of heart events – such as heart attacks, hospitalizations or death. However, for patients with preserved ejection fraction, researchers have so far been unsuccessful in finding a drug that can improve the prognosis and reduce the risk of cardiac events for patients.
However, our recent study has found that a common type of diabetes drug can help improve the health of patients with this type of heart failure by reducing the risk of death and hospitalization of a heart cause.
In recent years, researchers have shown that drugs that were originally designed to treat patients with diabetes – called SGLT2 inhibitors – have been shown to benefit people with reduced ejection fraction. Now, our recent study, which has combined data from other, smaller studies on the subject, has shown that SGLT2 inhibitors can also be used to treat patients with preserved ejection fraction. We found that patients who received SGLT2 inhibitors were 22% less likely to die from heart-related causes or be hospitalized due to heart failure than those who did not take them.
Diabetes drug
To conduct our study, we looked at data from nearly 10,000 patients with heart failure and preserved ejection fraction. Half of the patients were treated with an SGLT2 inhibitor, while the other half received placebo – a tablet that was similar to the new drug but did not contain any medicine. Patients took either the SGLT2 inhibitor or placebo continuously for an average of about two years, after which follow-up was stopped.
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SGLT2 inhibitors have only recently been shown to be extremely beneficial for patients with heart failure. Originally, they were designed to help lower blood sugar levels in people with type 2 diabetes.
SGLT2 inhibitors are thought to work in people with heart failure for a number of reasons. One theory is because they promote diuresis, which helps the body get rid of extra fluid, as fluid overload can be a significant problem for these patients. SGLT2 inhibitors also improve blood pressure and increase the production of red blood cells, which help supply blood supply and oxygen to the body’s main organs. Research also suggests that they also reduce the formation of scars in the heart muscle. Dealing with all of these factors is critical as they can lead to the formation or worsening of heart failure.
An additional benefit of using this drug to treat heart failure with preserved ejection fraction is that they have already been shown to be safe as they have been used to treat diabetes for many years. They also have relatively few side effects – although urinary tract infection or abnormal blood sugar can rarely be seen.
SGLT2 inhibitors are currently recommended by the European Society of Cardiology for the treatment of patients with heart failure and reduced ejection fraction, with and without diabetes. Our research is the first to suggest that it can also be used to significantly improve outcomes for patients with heart failure and preserved ejection fraction. This can mean that patients with both types of heart failure can receive treatment that improves their quality of life, symptoms and prognosis.
However, this medicine will not be prescribed for use in patients with preserved ejection fraction until it has been reviewed and approved by the National Institute for Health and Care Excellence.
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