{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T17:23:11Z","timestamp":1778260991739,"version":"3.51.4"},"reference-count":22,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T00:00:00Z","timestamp":1670371200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Aims<\/jats:title>\n                  <jats:p>Empagliflozin reduces the risk of cardiovascular death or heart failure (HF) hospitalization in patients with HF and preserved ejection fraction. This study aims to evaluate if systolic blood pressure (SBP) moderates these effects.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and results<\/jats:title>\n                  <jats:p>The association of SBP and the treatment effects of empagliflozin in EMPEROR-Preserved (empagliflozin outcome trial in patients with chronic heart failure with preserved ejection fraction) was evaluated. Randomized patients (n = 5988) were grouped according to SBP at baseline (&amp;lt;110\u2005mmHg, n = 455; 110\u2013130\u2005mmHg, n = 2415; &amp;gt; 130\u2005mmHg, n = 3118). The effect of empagliflozin on blood pressure, cardiovascular death or HF hospitalization (primary outcome), total HF hospitalizations, and rate of decline in estimated glomerular filtration rate was studied. Over a median of 26.2 months, the placebo-corrected decline was small and not significantly different across baseline SBP. On placebo, the risk of cardiovascular death or hospitalization for HF was 8.58 at &amp;gt;130\u2005mmHg, 8.26 at 110\u2013130\u2005mmHg, and 11.59 events per 100 patient-years at &amp;lt;110\u2005mmHg (P = 0.12 vs. &amp;gt; 130\u2005mmHg, P = 0.08 vs. 110\u2013130\u2005mmHg). There was no evidence for baseline SBP moderating the effect of empagliflozin on risk of HF events (primary endpoint interaction P = 0.69, recurrent HF hospitalizations interaction P = 0.55). When comparing empagliflozin with placebo, SBP did not meaningfully associate with adverse events such as hypotension, volume depletion, and acute renal failure.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In EMPEROR-Preserved, empagliflozin was effective and safe without SBP meaningfully moderating empagliflozin\u2019s treatment effects. This analysis of EMPEROR-Preserved shows that empagliflozin can be used safely and effectively without blood pressure being a meaningful moderator of the drug benefit.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Clinical Trial Registration<\/jats:title>\n                  <jats:p>URL: https:\/\/www.clinicaltrials.gov Unique identifier: NCT03057951<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurheartj\/ehac693","type":"journal-article","created":{"date-parts":[[2022,12,7]],"date-time":"2022-12-07T17:37:07Z","timestamp":1670434627000},"page":"396-407","source":"Crossref","is-referenced-by-count":42,"title":["Empagliflozin, irrespective of blood pressure, improves outcomes in heart failure with preserved ejection fraction: the EMPEROR-Preserved trial"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2976-2514","authenticated-orcid":false,"given":"Michael","family":"B\u00f6hm","sequence":"first","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Universit\u00e4tsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg, Saarland , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0805-8683","authenticated-orcid":false,"given":"Stefan","family":"Anker","sequence":"additional","affiliation":[{"name":"Department of Cardiology (CVK), and Berlin Institute of Health Center for Regenerative Therapies (BCRT) , Augustenburger Platz 1, 13353 Berlin , Germany"},{"name":"Centre for Cardiovascular Research (DZHK) partner site Berlin, Charit\u00e9 Universit\u00e4tsmedizin Berlin , Augustenburger Platz 1, 13353 Berlin , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4425-549X","authenticated-orcid":false,"given":"Felix","family":"Mahfoud","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Universit\u00e4tsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg, Saarland , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1434-9556","authenticated-orcid":false,"given":"Lucas","family":"Lauder","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III, Universit\u00e4tsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg, Saarland , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5640-0332","authenticated-orcid":false,"given":"Gerasimos","family":"Filippatos","sequence":"additional","affiliation":[{"name":"National and Kapodistrian University of Athens School of Medicine, Athens University Hospital Attikon , 1Rimini St, 12462 Athens , Greece"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2304-6138","authenticated-orcid":false,"given":"Jo\u00e3o Pedro","family":"Ferreira","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Centre d'Investigation Clinique- Plurith\u00e9matique Inserm CIC-P 1433 , 54500 Vandoeuvre-Les-Nancy , France"},{"name":"Inserm U1116, CHRU Nancy Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , 54500 Vandoeuvre-Les-Nancy , France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2212-4007","authenticated-orcid":false,"given":"Stuart J","family":"Pocock","sequence":"additional","affiliation":[{"name":"Department of Medical Statistics, London School of Hygiene & Tropical Medicine , Keppel Street, London WC1E 7HT , UK"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1215-0746","authenticated-orcid":false,"given":"Martina","family":"Brueckmann","sequence":"additional","affiliation":[{"name":"Boehringer Ingelheim International , Binger Str. 173, 55218 Ingelheim, Rheinland-Pfalz , Germany"},{"name":"First Department of Medicine, Faculty of Medicine Mannheim, University of Heidelberg , Grabengasse 1, 69117 Heidelberg, Baden-W\u00fcrttemberg , Germany"}]},{"given":"Ilias","family":"Saloustros","sequence":"additional","affiliation":[{"name":"Medical Department, Boehringer Ingelheim TA Cardiometabolism Respiratory Medicine , Ringstr. 173, 55218 Ingelheim , Germany"}]},{"given":"Elke","family":"Sch\u00fcler","sequence":"additional","affiliation":[{"name":"Mainanalytics GmbH, Sulzbach , Otto-Volger-Str. 3c, 65843 Sulzbach\/Taunus, Hessen , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9507-5301","authenticated-orcid":false,"given":"Christoph","family":"Wanner","sequence":"additional","affiliation":[{"name":"Medizinische Klinik und Poliklinik 1, Schwerpunkt Nephrologie, Universit\u00e4tsklinikum W\u00fcrzburg. Oberd\u00fcrrbacher Str. 6 , 97080 W\u00fcrzburg, Bayern , Germany"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7456-1570","authenticated-orcid":false,"given":"Faiez","family":"Zannad","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Lorraine, Centre d'Investigation Clinique- Plurith\u00e9matique Inserm CIC-P 1433 , 54500 Vandoeuvre-Les-Nancy , France"},{"name":"Inserm U1116, CHRU Nancy Brabois, F-CRIN INI-CRCT (Cardiovascular and Renal Clinical Trialists) , 54500 Vandoeuvre-Les-Nancy , France"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1828-2387","authenticated-orcid":false,"given":"Milton","family":"Packer","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute, Baylor University Medical Center , 3500 Gaston Ave, Dallas, TX 75246 , USA"},{"name":"Imperial College , Exhibition Road, SW7 2AZ London , UK"}]},{"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Heart and Vascular Institute, Baylor University Medical Center , 3500 Gaston Ave, Dallas, TX 75246 , USA"},{"name":"Department of Medicine, Department of Medicine (L650), University of Mississippi School of Medicine , 2500 N. 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