Optimizing Cardiovascular Outcome in Type 2 Diabetes Mellitus with Better Control of Diabetes Mellitus with Empigliflozin and Hypertension with Renin Angiotensin System Inhibitors and Manidipine Preferably of the Dihydropyridones

Kulvinder Kochar Kaur*, Gautam Allahbadia and Mandeep Singh

Optimizing Cardiovascular Outcome in Type 2 Diabetes Mellitus with Better Control of Diabetes Mellitus with Empigliflozin and Hypertension with Renin Angiotensin System Inhibitors and Manidipine Preferably of the Dihydropyridones.

With increasing obesity there is simultaneous rise in comorbidities like diabetes mellitus (DM) and hypertension (HTN), the commonest causes of cardiovascular diseases (CVD). While DM has more than 2-3 times increase in the incidence of is chemic heart disease in men than in women.
Since instance of obesity are rising out of proportion and although only 171 million people having DM in 2000, the rough calculation for 2030 is 350 million.

Earlier we have concentrated on etiopathogenesis of obesity, ways of improving medical management of obesity over bariatric surgery, considering diabesity together for management
of obesity and DM. This article is a review of how to effectively manage hypertension an important complication of obesity, that has an effect on cardiovascular outcome trials (CVOT) outcome
of antidiabetic therapies10-19 and further the advantages and role of manidipine over amlodipine addition to a renin-angiotensinā€“aldosterone system inhibitor is considered in detail.

There is 50% presence of insulin resistance (IR) in hypertensive patients that causes damage to the vessels, which includes abnormal function, stiffness of vessels, hypertrophy, fibrosis and
remodeling. Additionally, IR increases sympathetic output and aids in sodium reabsorption in the diluting segment of the distal nephron, causing reduced sodium excretion and ultimately higher blood pressure (BP) levels. Further IR also promotes renin-angiotensinaldosterone system.
Higher insulin volume along with sodium retention in the kidney along with activation of the SNS.20-23 Conversely oxidative stress because of reactive oxygen species (ROS) synthesis helps in the development of further IR, DM along with hypertension.

Obes Res Open J. 2020; 7(1): 1-13. doi: 10.17140/OROJ-7-141