Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus
The article discusses the pathophysiological mechanisms of the development of vascular aging as a combination of the influence on the body of genetic, environmental, regulatory, metabolic and other factors causing biochemical, enzymatic and cellular changes in the arterial vascular bed. The concep...
| Main Authors: | , , , |
|---|---|
| Format: | Article |
| Language: | Russian |
| Published: |
Remedium Group LLC
2021-09-01
|
| Series: | Медицинский совет |
| Subjects: | |
| Online Access: | https://www.med-sovet.pro/jour/article/view/6353 |
| _version_ | 1797841314625093632 |
|---|---|
| author | I. Sh. Khalimov Yu. Ye. Rubtsov V. V. Salukhov P. V. Agafonov |
| author_facet | I. Sh. Khalimov Yu. Ye. Rubtsov V. V. Salukhov P. V. Agafonov |
| author_sort | I. Sh. Khalimov |
| collection | DOAJ |
| description | The article discusses the pathophysiological mechanisms of the development of vascular aging as a combination of the influence on the body of genetic, environmental, regulatory, metabolic and other factors causing biochemical, enzymatic and cellular changes in the arterial vascular bed. The concept of “early vascular aging” and “healthy vascular aging” is defined depending on the ratio of the biological and chronological age of the vessels. The role of diabetes mellitus in increasing vascular stiffness, early vascular aging, as well as the progression of atherosclerotic cardiovascular diseases and their complications is considered in detail. Approaches to multifactorial management of vascular age in patients with type 2 diabetes (lifestyle modification with strategy of aggressive treatment of modifiers of atherosclerosis, rejection of bad habits, adherence to dietary recommendations and the use of modern organo- and vasoprotective antidiabetic drugs) are revealed. The mechanism of realization of vasoprotective effects of inhibitors of sodium-glucose transporter-2 (iNGLT-2) is described in detail. The results of completed large random ized trials EMPA-REG Outcome and EMPA-REG BP of the most studied representative of the IGLT-2 group, empagliflozin, are presented. It has been shown that due to their glucose and natriuretic effects, the ability to reduce body weight and blood pressure, improve myocardial metabolism and bioenergetics, decrease the activity of the sympathetic nervous system, as well as positive effects on vascular stiffness, NGLT-2 inhibitors are the drugs of choice in patients with type 2 diabetes mellitus (T2DM) and cardiovascular diseases. This makes it possible to widely use this group of drugs for managing the vascular age of patients and represents a new opportunity in the prevention of vascular aging in T2DM. |
| first_indexed | 2024-04-09T16:29:03Z |
| format | Article |
| id | doaj.art-d01c234916f5497fafcdbc6624a2cddd |
| institution | Directory Open Access Journal |
| issn | 2079-701X 2658-5790 |
| language | Russian |
| last_indexed | 2024-04-09T16:29:03Z |
| publishDate | 2021-09-01 |
| publisher | Remedium Group LLC |
| record_format | Article |
| series | Медицинский совет |
| spelling | doaj.art-d01c234916f5497fafcdbc6624a2cddd2023-04-23T06:57:12ZrusRemedium Group LLCМедицинский совет2079-701X2658-57902021-09-0101222823610.21518/2079-701X-2021-12-228-2365731Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitusI. Sh. Khalimov0Yu. Ye. Rubtsov1V. V. Salukhov2P. V. Agafonov3Military Medical Academy named after S.M. KirovMilitary Medical Academy named after S.M. KirovMilitary Medical Academy named after S.M. KirovMilitary Medical Academy named after S.M. KirovThe article discusses the pathophysiological mechanisms of the development of vascular aging as a combination of the influence on the body of genetic, environmental, regulatory, metabolic and other factors causing biochemical, enzymatic and cellular changes in the arterial vascular bed. The concept of “early vascular aging” and “healthy vascular aging” is defined depending on the ratio of the biological and chronological age of the vessels. The role of diabetes mellitus in increasing vascular stiffness, early vascular aging, as well as the progression of atherosclerotic cardiovascular diseases and their complications is considered in detail. Approaches to multifactorial management of vascular age in patients with type 2 diabetes (lifestyle modification with strategy of aggressive treatment of modifiers of atherosclerosis, rejection of bad habits, adherence to dietary recommendations and the use of modern organo- and vasoprotective antidiabetic drugs) are revealed. The mechanism of realization of vasoprotective effects of inhibitors of sodium-glucose transporter-2 (iNGLT-2) is described in detail. The results of completed large random ized trials EMPA-REG Outcome and EMPA-REG BP of the most studied representative of the IGLT-2 group, empagliflozin, are presented. It has been shown that due to their glucose and natriuretic effects, the ability to reduce body weight and blood pressure, improve myocardial metabolism and bioenergetics, decrease the activity of the sympathetic nervous system, as well as positive effects on vascular stiffness, NGLT-2 inhibitors are the drugs of choice in patients with type 2 diabetes mellitus (T2DM) and cardiovascular diseases. This makes it possible to widely use this group of drugs for managing the vascular age of patients and represents a new opportunity in the prevention of vascular aging in T2DM.https://www.med-sovet.pro/jour/article/view/6353vascular agingtype 2 diabetes mellitusarterial stiffnesssglt-2 inhibitorsempagliflozin |
| spellingShingle | I. Sh. Khalimov Yu. Ye. Rubtsov V. V. Salukhov P. V. Agafonov Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus Медицинский совет vascular aging type 2 diabetes mellitus arterial stiffness sglt-2 inhibitors empagliflozin |
| title | Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus |
| title_full | Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus |
| title_fullStr | Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus |
| title_full_unstemmed | Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus |
| title_short | Inhibitors of the sodium-glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus |
| title_sort | inhibitors of the sodium glucose transporter type 2 and new possibilities for managing vascular age in patients with type 2 diabetes mellitus |
| topic | vascular aging type 2 diabetes mellitus arterial stiffness sglt-2 inhibitors empagliflozin |
| url | https://www.med-sovet.pro/jour/article/view/6353 |
| work_keys_str_mv | AT ishkhalimov inhibitorsofthesodiumglucosetransportertype2andnewpossibilitiesformanagingvascularageinpatientswithtype2diabetesmellitus AT yuyerubtsov inhibitorsofthesodiumglucosetransportertype2andnewpossibilitiesformanagingvascularageinpatientswithtype2diabetesmellitus AT vvsalukhov inhibitorsofthesodiumglucosetransportertype2andnewpossibilitiesformanagingvascularageinpatientswithtype2diabetesmellitus AT pvagafonov inhibitorsofthesodiumglucosetransportertype2andnewpossibilitiesformanagingvascularageinpatientswithtype2diabetesmellitus |