The decreased risk of heart failure associated with SGLT-2 inhibitors may be imparted by their haemodynamic effects on the heart, such as reduced intravascular volume, improved arterial elasticity, and decreased cardiac preload and afterload.4041 Concerning their renoprotective effects, SGLT-2 inhibitors ameliorate hyperfiltration in the proximal tubules, which reduces intraglomerular pressure.42 Thus, the decreased cardiorenal risk associated with the combined use of GLP-1 receptor agonists and SGLT-2 inhibitors may be attributed to an additive effect, achieved by the distinct mechanisms and sites of action for these different drug classes
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