Type 2 diabetes mellitus and cardiovascular risk; what the pharmacotherapy can change through the epigenetics

ABSTRACT

Diabetes mellitus and cardiovascular diseases are part of the metabolic syndrome and share similar risk factors, including obesity, arterial hypertension, and dyslipidemia. Atherosclerosis and insulin resistance contribute to the development of the diseases, and subclinical inflammation is observed in both conditions. There are many proofs about the connection between epigenetic factors and different diseases, including diabetes and cardiovascular diseases. Interestingly, recent studies show that at least some anti-diabetic drugs, as well as blockers of the renin-angiotensin-aldosterone system (RAAS), exert epigenetic effects aside from their hypoglycemic and antihypertensive functions, respectively. More studies are needed to discover other positive effects of the medications established through epigenetic mechanisms and to find out more about the epigenetic role in the development of diabetes mellitus and cardiovascular diseases.

KEYWORDS:

• Diabetes mellitus
• pharmacotherapy
• renin-angiotensin system
• epigenetics

Declaration of interest

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This work is supported by the Council of Medical Sciences of Medical University of Sofia [Grant D-66/23.04.2019].