Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs
Hypertension poses a significant burden in the general population, being responsible for increasing cardiovascular morbidity and mortality, leading to adverse outcomes. Moreover, the association of hypertension with dyslipidaemia, obesity, and insulin resistance, also known as metabolic syndrome, fu...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2023-01-01
|
| Series: | Metabolites |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2218-1989/13/1/87 |
| _version_ | 1797438771663208448 |
|---|---|
| author | Silviu Stanciu Emilia Rusu Daniela Miricescu Ana Cristina Radu Bianca Axinia Ana Maria Vrabie Ruxandra Ionescu Mariana Jinga Carmen Adella Sirbu |
| author_facet | Silviu Stanciu Emilia Rusu Daniela Miricescu Ana Cristina Radu Bianca Axinia Ana Maria Vrabie Ruxandra Ionescu Mariana Jinga Carmen Adella Sirbu |
| author_sort | Silviu Stanciu |
| collection | DOAJ |
| description | Hypertension poses a significant burden in the general population, being responsible for increasing cardiovascular morbidity and mortality, leading to adverse outcomes. Moreover, the association of hypertension with dyslipidaemia, obesity, and insulin resistance, also known as metabolic syndrome, further increases the overall cardiovascular risk of an individual. The complex pathophysiological overlap between the components of the metabolic syndrome may in part explain how novel antidiabetic drugs express pleiotropic effects. Taking into consideration that a significant proportion of patients do not achieve target blood pressure values or glucose levels, more efforts need to be undertaken to increase awareness among patients and physicians. Novel drugs, such as incretin-based therapies and renal glucose reuptake inhibitors, show promising results in decreasing cardiovascular events in patients with metabolic syndrome. The effects of sodium-glucose co-transporter-2 inhibitors are expressed at different levels, including renoprotection through glucosuria, natriuresis and decreased intraglomerular pressure, metabolic effects such as enhanced insulin sensitivity, cardiac protection through decreased myocardial oxidative stress and, to a lesser extent, decreased blood pressure values. These pleiotropic effects are also observed after treatment with glucagon-like peptide-1 receptor agonists, positively influencing the cardiovascular outcomes of patients with metabolic syndrome. The initial combination of the two classes may be the best choice in patients with type 2 diabetes mellitus and multiple cardiovascular risk factors because of their complementary mechanisms of action. In addition, the novel mineralocorticoid receptor antagonists show significant cardio-renal benefits, as well as anti-inflammatory and anti-fibrotic effects. Overall, the key to better control of hypertension in patients with metabolic syndrome is to consider targeting multiple pathogenic mechanisms, using a combination of the different therapeutic agents, as well as drastic lifestyle changes. This article will briefly summarize the association of hypertension with metabolic syndrome, as well as take into account the influence of antidiabetic drugs on blood pressure control. |
| first_indexed | 2024-03-09T11:42:08Z |
| format | Article |
| id | doaj.art-03c876e0d7be4e31a7e488cc3e773ccf |
| institution | Directory Open Access Journal |
| issn | 2218-1989 |
| language | English |
| last_indexed | 2024-03-09T11:42:08Z |
| publishDate | 2023-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Metabolites |
| spelling | doaj.art-03c876e0d7be4e31a7e488cc3e773ccf2023-11-30T23:28:49ZengMDPI AGMetabolites2218-19892023-01-011318710.3390/metabo13010087Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic DrugsSilviu Stanciu0Emilia Rusu1Daniela Miricescu2Ana Cristina Radu3Bianca Axinia4Ana Maria Vrabie5Ruxandra Ionescu6Mariana Jinga7Carmen Adella Sirbu8Department of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital, 050474 Bucharest, RomaniaDepartment of Diabetology, “Carol Davila” University of Medicine and Pharmacy, Malaxa Clinica Hospital, 02441 Bucharest, RomaniaDepartment of Biochemistry, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, RomaniaMalaxa Clinical Hospital, 02441 Bucharest, RomaniaDepartment of Cardiology, Central Military Emergency University Hospital, 050474 Bucharest, RomaniaDepartment of Cardiology, Carol Davila University of Medicine and Pharmacy, Colentina Clinical Hospital, 020125 Bucharest, RomaniaDepartment of Cardiology, Central Military Emergency University Hospital, 050474 Bucharest, RomaniaDepartment of Internal Medicine and Gastroenterology, Carol Davila University of Medicine and Pharmacy, Central Military Emergency University Hospital, 050474 Bucharest, RomaniaDepartment of Neurology, Central Military Emergency University Hospital, 050474 Bucharest, RomaniaHypertension poses a significant burden in the general population, being responsible for increasing cardiovascular morbidity and mortality, leading to adverse outcomes. Moreover, the association of hypertension with dyslipidaemia, obesity, and insulin resistance, also known as metabolic syndrome, further increases the overall cardiovascular risk of an individual. The complex pathophysiological overlap between the components of the metabolic syndrome may in part explain how novel antidiabetic drugs express pleiotropic effects. Taking into consideration that a significant proportion of patients do not achieve target blood pressure values or glucose levels, more efforts need to be undertaken to increase awareness among patients and physicians. Novel drugs, such as incretin-based therapies and renal glucose reuptake inhibitors, show promising results in decreasing cardiovascular events in patients with metabolic syndrome. The effects of sodium-glucose co-transporter-2 inhibitors are expressed at different levels, including renoprotection through glucosuria, natriuresis and decreased intraglomerular pressure, metabolic effects such as enhanced insulin sensitivity, cardiac protection through decreased myocardial oxidative stress and, to a lesser extent, decreased blood pressure values. These pleiotropic effects are also observed after treatment with glucagon-like peptide-1 receptor agonists, positively influencing the cardiovascular outcomes of patients with metabolic syndrome. The initial combination of the two classes may be the best choice in patients with type 2 diabetes mellitus and multiple cardiovascular risk factors because of their complementary mechanisms of action. In addition, the novel mineralocorticoid receptor antagonists show significant cardio-renal benefits, as well as anti-inflammatory and anti-fibrotic effects. Overall, the key to better control of hypertension in patients with metabolic syndrome is to consider targeting multiple pathogenic mechanisms, using a combination of the different therapeutic agents, as well as drastic lifestyle changes. This article will briefly summarize the association of hypertension with metabolic syndrome, as well as take into account the influence of antidiabetic drugs on blood pressure control.https://www.mdpi.com/2218-1989/13/1/87hypertensionmetabolic syndrometype 2 diabetes mellitusinsulin resistancemetabolismobesity |
| spellingShingle | Silviu Stanciu Emilia Rusu Daniela Miricescu Ana Cristina Radu Bianca Axinia Ana Maria Vrabie Ruxandra Ionescu Mariana Jinga Carmen Adella Sirbu Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs Metabolites hypertension metabolic syndrome type 2 diabetes mellitus insulin resistance metabolism obesity |
| title | Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs |
| title_full | Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs |
| title_fullStr | Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs |
| title_full_unstemmed | Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs |
| title_short | Links between Metabolic Syndrome and Hypertension: The Relationship with the Current Antidiabetic Drugs |
| title_sort | links between metabolic syndrome and hypertension the relationship with the current antidiabetic drugs |
| topic | hypertension metabolic syndrome type 2 diabetes mellitus insulin resistance metabolism obesity |
| url | https://www.mdpi.com/2218-1989/13/1/87 |
| work_keys_str_mv | AT silviustanciu linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT emiliarusu linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT danielamiricescu linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT anacristinaradu linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT biancaaxinia linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT anamariavrabie linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT ruxandraionescu linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT marianajinga linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs AT carmenadellasirbu linksbetweenmetabolicsyndromeandhypertensiontherelationshipwiththecurrentantidiabeticdrugs |