Empagliflozin Reversal of Arterial StiffnEss in Aging

Inclusion Criteria

• Able to provide consent
• 60 to 80 years of age at randomization (women must be postmenopausal defined as more than 1 year without menses)
• Stable anti-hypertensive medication regimen (if in use) for at least 90 days
• Evidence of arterial stiffening (defined as carotid-femoral PWV >/= 8 m/s) at the time of screening visit.

Exclusion Criteria

• Diabetes
• BMI>/= 45kg/m2
• Known history of cardiovascular disease: heart failure, ischemic heart disease, peripheral artery disease or stroke
• Estimated glomerular filtration rate GFR \< 29 mL/min
• Active cancer (excluding basal cell carcinoma or stage 1 squamous cell carcinoma of the skin)
• Excessive alcohol consumption (>14 drinks/week for men, >7 drinks/week for women)
• Use of hormone replacement therapy
• Body weight change ≥10% within the last 6 months
• Uncontrolled hypertension during screening visit (>180/110 mmHg)
• Symptomatic hypotension and/or a SBP \<100 mmHg
• History of ketoacidosis
• High fall risk per assessment of study physician and/or safety officer at the time of screening (results must be abnormal for both fall risk assessments and orthostatic blood pressure measurements)
• Anticipated need of prolonged fasting
• History of recurrent UTIs or mycotic genital infections
• Following a low-carbohydrate diet (\<20 grams/day)
• Participation in regular exercise > 3 days/week per week at a moderate or vigorous intensity
• Known sensitivity to nitrate medications