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Therefore, the SGLT2-i induced elevated ANG II levels could act through AT2R resulting in vasodilation, sodium excretion, antiproliferative and anti-inflammation effects ( In addition, it has also been observed a SGLT2-i induced ACE2/ANG(1-7) pathway activation that may play a role in cardioprotection by competing with ANG II and AT1R ( Furthermore, the SGLT2-i “hybrid” diuretic effect, which combines natriuresis and osmotic diuresis, might also have cardioprotective properties leading to preload and myocardial stretch reduction (“the diuretic hypothesis”) ( Therefore, SGLT2-i diuretic properties show a major advantage compared to thiazides and thiazides-like diuretics, which act on the Na + CL - -cotransporter in the distal convoluted tubule, or loop diuretics, which block the Na-K-2Cl co-transporter of both the Henle loop and the macula densa, making the macula insensitive to the increased tubular sodium coming from the Henle loop

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