The Effects of Combined Antihypertensive and Antidiabetic Therapies on Cardiovascular Outcomes: A Systematic Review and Meta‐Analysis
Authors' conclusion
AHTN+ADA co-therapy was associated with improved CV outcomes and modest BP reduction compared with monotherapy, with effects predominantly driven by SGLT2 inhibitor-based combinations. Exploratory evidence indicates that GLP-1 RAs provide complementary reductions in CV outcomes and mortality but not HF events.
Study context
- Population
- Randomised controlled trials (RCTs) comparing combined antihypertensive (AHTN)+and antidiabetic (ADA) vs AHTN or ADA alone, reporting cardiovascular (CV) events and/or blood pressure (BP)/heart rate outcomes; databases searched from inception through November 2025
- Participants
- 13,955 participants9 RCTs
- Comparison
- Combined antihypertensive + antidiabetic therapy vs AHTN or ADA alone
- Outcome
- CV events (composite CV events, CV death, HF hospitalisation) and BP
Methodological detailsrandom-effects models, prespecified exploratory analysis of GLP-1 RA CV outcome trials vs placebo
- Random-effects models
- Prespecified exploratory analysis of GLP-1 RA CV outcome trials vs placebo
Pooled result
As reported in the abstract
Combination therapy: modest but significant systolic BP reduction (MD)
−2.57 mmHg
Combination therapy: modest but significant diastolic BP reduction (MD)
−1.03 mmHg
Further pooled results
- Seven GLP-1 RA trials (n = ≈56 000): reductions in composite CV events and CV death vs placebo, no effect on HF hospitalisation
- Exploratory analysis
Safety
- No excess risk of hypotension with combination therapy
Original publication
The Effects of Combined Antihypertensive and Antidiabetic Therapies on Cardiovascular Outcomes: A Systematic Review and Meta‐Analysis. Diabetes Obes Metab. Published 20 May 2026. doi:10.
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