Effects of SGLT2 Inhibitors in Pre-heart Failure Populations With Hypertension

Inclusion criteria

• Meeting all the following criteria:
• Aged 18 years and above.
• Hypertensive patients currently taking at least one antihypertensive medication as recommended by guidelines, and blood pressure is within the target range (\<140/90 mmHg).
• Within 3 months prior to screening，result meet any of the following criteria:
• Left atrial volume index \> 34 mL/m² measured by echocardiography;
• Average E/e' \> 9 measured by echocardiography;
• NT-proBNP \> 125 ng/ml.
• Signing an informed consent form.

Exclusion criteria

• • Exclusion criteria include any of the following conditions:
• History of diabetes.
• History of heart failure.
• History of myocardial infarction, acute coronary syndrome within the past 6 months, or planned coronary revascularization within the next 6 months
• Left ventricular systolic dysfunction, defined as LVEF \< 50%.
• Systolic blood pressure \< 100 mmHg.
• A history of arrhythmias such as atrial fibrillation, atrial flutter, frequent atrial premature contractions, and frequent ventricular premature contractions may impact the structural and functional aspects of the heart.
• Moderate and above valvular heart disease.
• Severe obstructive disease of the left ventricular outflow tract, including aortic valve stenosis.
• Confirmed diagnosis of cardiomyopathy and infiltrative myocardial diseases.
• Visited within the past 1 month due to Genitourinary tract infection.
• Chronic kidney disease or estimated Glomerular Filtration Rate (eGFR) \< 45 ml/min/1.73m².
• Alanine aminotransferase or aspartate aminotransferase levels \> 3 times the upper limit of normal.
• Contraindications to taking SGLT2 inhibitors.
• Currently taking SGLT2 inhibitors, SGLT-1/2 inhibitors, or other antihyperglycemic medications (including metformin, glucagon-like peptide-1 receptor agonists, etc.).
• Pregnancy or planning pregnant, or currently breastfeeding.
• Malignant tumors or other severe illnesses with a life expectancy of less than 3 years.
• History of alcohol abuse or substance abuse within the past year.
• Mental disorders or communication barriers, cognitive impairments, or other severe illnesses that may affect participation in the study.
• Participation in or currently participating in other clinical trials within the last 3 months.
• Known poor compliance with study follow-up or study drug.
• Any condition or contraindication that makes a person intolerant to magnetic resonance imaging (MRI) or contraindicates MRI examination, such as the presence of implanted intracranial aneurysm clips, cardiac pacemakers or defibrillators, insulin pumps, etc.