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<p>Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are two prevalent and interrelated conditions that share common pathophysiological mechanisms, including insulin resistance and chronic inflammation. While newer glucose-lowering agents such as sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown promise in improving insulin sensitivity and cardiovascular outcomes, a number of commonly used cardiovascular pharmacologic agents such as thiazide diuretics, beta-blockers, and statins have been associated with adverse effects on glucose metabolism, including increased insulin resistance and elevated risk of T2DM. This narrative review examines both the detrimental and beneficial metabolic effects of various cardiovascular drugs, explores their underlying mechanisms, and discusses the implications for the prevention and management of metabolic dysfunction in patients at high cardiometabolic risk. A clearer understanding of these effects is crucial for optimizing therapeutic strategies in individuals with or at risk for both CVD and T2DM.</p>

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Cardiovascular Pharmacotherapy and Glucose Metabolism: The Good, the Bad and the Unsightly

  • 期刊论文

  • 发表日期：

    2025年11月17日

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  • Rosana G. Bianchettin,
  • Paul Poirier,
  • Francisco Lopez-Jimenez,
  • Carl J. Lavie,
  • Marie-Eve Piché

摘要

Cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM) are two prevalent and interrelated conditions that share common pathophysiological mechanisms, including insulin resistance and chronic inflammation. While newer glucose-lowering agents such as sodium-glucose cotransporter 2 (SGLT2) inhibitors and glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown promise in improving insulin sensitivity and cardiovascular outcomes, a number of commonly used cardiovascular pharmacologic agents such as thiazide diuretics, beta-blockers, and statins have been associated with adverse effects on glucose metabolism, including increased insulin resistance and elevated risk of T2DM. This narrative review examines both the detrimental and beneficial metabolic effects of various cardiovascular drugs, explores their underlying mechanisms, and discusses the implications for the prevention and management of metabolic dysfunction in patients at high cardiometabolic risk. A clearer understanding of these effects is crucial for optimizing therapeutic strategies in individuals with or at risk for both CVD and T2DM.