What emerging HF therapy class provides mortality and hospitalization benefits beyond glucose control, even in non-diabetics?

• A. ACE inhibitors
• B. Beta blockers
• C. SGLT2 inhibitors
• D. ARBs

Answer: (C)

SGLT2 inhibitors are the class that fit this description. These drugs, originally developed to lower blood glucose in diabetes, have shown clear heart failure benefits that extend beyond glycemic control and apply even to people without diabetes.

Key trials in heart failure demonstrated meaningful reductions in death and hospitalization for heart failure with agents like dapagliflozin and empagliflozin in patients with reduced ejection fraction, and similar benefits in many with preserved ejection fraction. Importantly, these benefits occurred regardless of diabetes status, highlighting effects beyond glucose lowering.

The benefits come from multiple mechanisms beyond lowering glucose: they promote natriuresis and diuresis, reduce preload and afterload, improve renal function and kidney-heart crosstalk, and may enhance myocardial energy efficiency and reduce inflammation. This combination translates into lower mortality and fewer heart failure hospitalizations, which is why this class is viewed as an important and relatively new advance in heart failure therapy for diverse patient populations.