Yesterday I told the story of a good friend with repeated chest pain and explained how it is due in part to microvascular disease and decreased nitric oxide production. You also learned that a nitroglycerin tablet under the tongue increases nitric oxide levels in the blood. Viagra does the same thing. I had previously written about metformin cutting heart muscle damage in half in experimentally induced heart attack. This article proves metformin reduces the size of a stroke by switching on AMPK which increases nitric oxide production. Microvascular disease and decreased nitric oxide production by the inner lining of these arteries is a core feature of organ damage by cardiometabolic conditions.
ACE inhibitors like lisinopril, ARBs like losartan, statins, MR antagonists like spironolactone, metformin, and SGLT2 inhibitors like empagliflozin all switch on AMPK and increase nitric oxide production. Intermittent fasting, caloric restriction, and exercise do the same thing. These interventions restore the artery to a more normal state. That is why optimal medical therapy is so much more effective than usual care in patients with cardiovascular and related conditions like hypertension and diabetes. Lowering risk factors like blood pressure and sugar have some benefit. Changing the molecular biology that causes chronic disease and aging is even more beneficial. “it is now critical for physicians to reconceptualize SGLT2 inhibitors as organ-protective agents rather than glucose-lowering drugs. The antihyperglycemic action of these drugs represents a tiny fraction of their broad portfolio of effects” It is critical that we manipulate the molecular biology that causes cardiometabolic disease by integrating the interventions mentioned above to produce better clinical and financial outcomes. Does that help you understand?
Yup!
Here we go!
https://www.linkedin.com/posts/joseph-thomas-shen-md-b01760106_is-recurrent-a-fib-detectable-we-believe-activity-6921095090954190848-fBVG?utm_source=linkedin_share&utm_medium=member_desktop_web