SGLT2 inhibitor use helps reduce cardiovascular, renal deaths

Patients with diabetes mellitus, heart failure, or chronic kidney disease treated with sodium glucose co-transporter-2 inhibitors (SGLT2i) have a reduced risk of mortality from cardiovascular and renal causes, according to a study.

A group of researchers conducted a systematic literature search on electronic databases for relevant randomized controlled trials (RCTs) from inception until 10 September 2025. They calculated the risk ratios (RRs) with corresponding 95 percent confidence intervals (CIs) using a random-effects model.

Eighteen RCTs, including a total of 95,913 patients, met the eligibility criteria. Compared with control, SGLT2i use did not significantly lower overall all-cause mortality risk (RR, 0.92, 95 percent CI, 0.80‒1.05) but did so among older patients aged >65 years (RR, 0.93, 95 percent CI, 0.87‒0.98).

Noncardiovascular mortality was neutral overall (RR, 0.94, 95 percent CI, 0.86‒1.02) but was lower in younger patients aged <65 years (RR, 0.87, 95 percent CI, 0.78‒0.96).

Furthermore, treatment with SGLT2i correlated with significant reductions in cardiovascular (RR, 0.86, 95 percent CI, 0.81‒0.92) and renal mortality (RR, 0.31, 95 percent CI, 0.11‒0.90). This beneficial effect was consistent across age and follow-up subgroups for cardiovascular death.

“Notably, subgroup analyses further suggest potential all-cause mortality benefit in older adults and noncardiovascular mortality benefit in younger patients,” the researchers said. “These findings, though exploratory, carry meaningful implications for personalizing SGLT2i therapy across the lifespan.”