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Obesity, a driver of inflammation, is prevalent in patients with HFpEF. Ileana Pina asks Ambarish Pandey about GLP-1 inhibitors and SGLT2 inhibitors in HFpEF. Are these drugs anti-inflammatory? https://www.medscape.com/viewarticle/993980?src=soc_yt -TRANSCRIPT- Ileana L. Piña, MD, MPH: Hello, everyone. I'm Ileana Piña, professor of medicine at Jefferson University Hospital in Philadelphia. I'm the chief of quality. This is my blog. We have been hearing a lot of conversation about obesity. It's coming out of our endocrine division and our weight management division. And the patients are asking for things like bariatric surgery and maybe a holistic program of weight loss. A lot of the primary care doctors are starting to recommend glucagon-like peptide-1 (GLP-1) receptor agonists for those patients. But we deal with patients with heart failure with preserved ejection fraction (HFpEF), and a lot of our phenotypes are patients with obesity who happen to have hypertension and/or diabetes, and they are difficult to manage. Inflammation, Obesity, and HFpEF Piña: For today's conversation, there is nobody better than Dr Ambarish Pandey, who has a HFpEF program at the University of Texas Southwestern. Ambarish, welcome. Give me your thoughts overall about the link between obesity, inflammation, and HFpEF. Ambarish Pandey, MD: Thank you, Dr Piña. I'm excited to be on your blog and I'm glad that we are discussing such an important topic. The burden of heart failure, particularly HFpEF, has been increasing and is not just affecting older individuals. We see more younger folks with obesity in our HFpEF clinic coming in with symptoms of shortness of breath and fluid buildup. Our understanding of HFpEF has evolved quite a bit over the past two or three decades. Initially, it was thought to be a disease of largely impaired myocardial relaxation. And then Walter Paulus was one of the pioneers who proposed the concept of inflammation leading to HFpEF, and obesity being one of the important drivers of the inflammation that leads to the development of HFpEF. Now our understanding of HFpEF has evolved to it being a multisystem disorder that leads to dysfunction in different organ systems. One of the cardinal features that drives this dysfunction is upregulation of inflammatory pathways, increased inflammatory burden — and a lot of that is driven by obesity. Obesity is one of the most important modifiable risk factors for HFpEF. Piña: It is so common. In my clinic the other day, probably 3 out of 4 patients were obese. Pandey: Up to 75% of patients that we see in our program are over the 30 BMI cut-off, and a lot of the literature that has come from US HFpEF cohorts shows a very high average BMI in these patients. Piña: When we talk about inflammation, what are the chemical pathways of inflammation? For example, a long time ago, we tried to block TNF-alpha and it didn't quite work out. So, what pathways are we talking about? Pandey: I think a lot more work needs to be done to really understand the key drivers of inflammation and what pathways are being upregulated. As we know, inflammation is most commonly identified by elevation in levels of C-reactive protein (CRP), which serves as a marker of increased inflammation, but the upstream upregulation in IL-1– and IL-6–mediated pathways has been implicated in inflammation that drives development of diseases like HFpEF. There is an ongoing trial of ziltivekimab, which is an IL-1 inhibitor in patients with HFpEF. That's the HERMES trial led by Paul Ridker, one of the pioneers of inflammatory therapies in heart disease. We are starting to understand more about the key molecular pathways that are driving it. And now we're starting to target them, with the hope that we can actually halt the progression of HFpEF and improve the symptom burden as well as the risk for adverse outcomes in these patients. Are GLP-1 Inhibitors Anti-inflammatory? Piña: Do you think that the GLP-1s, or even now the SGLT2 inhibitors, are anti-inflammatory since we really don't know all the pathways? Pandey: I do think that GLP-1s, by virtue of causing weight loss and reduction in visceral adiposity and the bad fat depots that exist in our body, have a significant anti-inflammatory effect. And if you look at the data from the STEP trials that were done, looking at weight loss effects of semaglutide, a commonly used GLP-1 inhibitor, there was a good 30%-40% reduction in CRP levels, and that suggests that there is a significant anti-inflammatory effect. Now, whether it's a direct effect on anti-inflammatory pathways or is related to weight loss is a matter of debate. Piña: Are you using GLP-1 inhibitors in your HFpEF clinic? And what trials can we look forward to seeing concerning the use of these agents? https://www.medscape.com/viewarticle/993980?src=soc_yt
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Are you looking to take your ketogenic experience to the next level? Look no further than Apex Keto Plus. This revolutionary supplement is designed to enhance your ketosis journey, helping you reach your weight loss and fitness goals faster and more effectively. Whether you’re new to the ketogenic diet or a seasoned pro, Apex Keto Plus can help you maximize your results and achieve the body of your dreams. Read on to learn more about how Apex Keto Plus can transform your ketogenic experience.
The Science Behind Apex Keto Plus
Apex Keto Plus is formulated with a powerful blend of BHB ketones, which are known to kickstart and maintain ketosis in the body. When you consume Apex Keto Plus, the exogenous ketones in the supplement help your body enter ketosis more quickly and stay in ketosis longer. This can lead to increased fat burning, improved energy levels, and enhanced mental clarity. By supplementing with Apex Keto Plus, you can amplify the benefits of the ketogenic diet and see results faster than ever before.
Furthermore, Apex Keto Plus contains a unique combination of natural ingredients that are proven to support overall health and well-being. From metabolism-boosting compounds to antioxidants that fight inflammation, Apex Keto Plus is more than just a weight loss supplement—it’s a comprehensive solution for optimal health. With regular use, you can experience not only a slimmer waistline but also improved digestion, better immune function, and increased vitality.
How to Incorporate Apex Keto Plus into Your Routine
Adding Apex Keto Plus to your daily routine is easy and convenient. Simply take the recommended dosage of capsules with a glass of water, preferably in the morning or before your workout. The supplement is fast-acting, so you should start feeling the effects soon after taking it. To maximize the benefits of Apex Keto Plus, be sure to follow a healthy ketogenic diet and engage in regular exercise. By combining all three elements—Apex Keto Plus, diet, and exercise—you can supercharge your weight loss efforts and achieve your goals in no time.
It’s important to note that individual results may vary, and consistency is key when it comes to seeing the full benefits of Apex Keto Plus. While some users may experience rapid weight loss and increased energy levels right away, others may take longer to notice changes. Remember to listen to your body, stay hydrated, and be patient with yourself throughout your ketogenic journey. With dedication and commitment, you can unlock the full potential of Apex Keto Plus and take your ketosis experience to new heights.
Frequently Asked Questions about Apex Keto Plus
1. How soon can I expect to see results with Apex Keto Plus?
Results may vary, but many users report feeling more energized and seeing weight loss within the first week of taking Apex Keto Plus. For best results, continue taking the supplement consistently and follow a healthy ketogenic diet.
2. Are there any side effects associated with Apex Keto Plus?
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Apex Keto Plus is made with natural ingredients and is generally well-tolerated by most users. However, some individuals may experience minor side effects like stomach upset or headaches during the initial adaptation phase. If you have any concerns, consult with your healthcare provider before using Apex Keto Plus.
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Are you looking for a convenient and tasty way to support your ketogenic diet? Ultimate Health Keto Gummies claim to be the ultimate solution for those wanting to achieve ketosis and lose weight effectively. But with so many keto products on the market, are these gummies really the best choice for your diet? In this article, we will dive deep into the world of Ultimate Health Keto Gummies to help you make an informed decision.
What Are Ultimate Health Keto Gummies?
Ultimate Health Keto Gummies are a dietary supplement designed to support ketogenic diets. These gummies are formulated with ingredients like BHB (beta-hydroxybutyrate) to help your body enter ketosis more quickly. Ketosis is a metabolic state where your body burns fat for energy instead of carbs, leading to weight loss. The gummies come in a convenient and delicious form, making them easy to incorporate into your daily routine.
Users are instructed to take 2 gummies daily to support their ketogenic journey. The gummies are said to help reduce cravings, increase energy levels, and improve focus. With no artificial ingredients or harmful chemicals, Ultimate Health Keto Gummies are marketed as a safe and effective way to enhance your keto diet.
These gummies are not meant to replace a healthy diet and regular exercise but rather to complement your efforts in achieving ketosis. Whether you are new to the ketogenic diet or a seasoned veteran, Ultimate Health Keto Gummies claim to be a valuable tool in your weight loss journey.
Are Ultimate Health Keto Gummies Worth It?
With so many keto products flooding the market, it can be challenging to determine which ones are worth your time and money. Ultimate Health Keto Gummies have garnered attention for their innovative formula and promising results. However, it is essential to consider various factors before deciding if these gummies are the best choice for your diet.
One of the key advantages of Ultimate Health Keto Gummies is their convenience. Unlike traditional supplements that come in pill form, these gummies are easy to consume on the go. They are also available in delicious flavors, making them a more enjoyable option for those who struggle with swallowing pills.
In addition to convenience, Ultimate Health Keto Gummies are formulated with high-quality ingredients to support your ketogenic lifestyle. The BHB in these gummies can help jumpstart ketosis and accelerate your weight loss journey. By incorporating these gummies into your routine, you may experience increased energy levels, reduced cravings, and improved mental clarity.
How to Incorporate Ultimate Health Keto Gummies Into Your Diet
For optimal results, it is essential to use Ultimate Health Keto Gummies as directed. Take 2 gummies daily, either with or without food, to support your ketogenic diet. These gummies can be consumed at any time of the day, making it easy to fit them into your schedule.
While Ultimate Health Keto Gummies can help enhance your weight loss efforts, they work best when combined with a healthy diet and regular exercise. Focus on eating whole, nutrient-dense foods and staying active to maximize the benefits of these gummies. Remember that consistency is key when it comes to achieving your health and wellness goals.
Listen to your body while taking Ultimate Health Keto Gummies. Pay attention to how you feel and any changes you experience. If you have any concerns or unusual reactions, consult with a healthcare professional before continuing use. Your health and well-being should always come first.
Final Thoughts on Ultimate Health Keto Gummies
Ultimately, the decision to try Ultimate Health Keto Gummies will depend on your individual needs and preferences. If you are looking for a convenient and effective way to support your ketogenic diet, these gummies may be worth considering. Their innovative formula, delicious flavors, and promising results make them a popular choice among those following a keto lifestyle.
Before incorporating any new supplement into your routine, it is crucial to do your research and consult with a healthcare provider. While Ultimate Health Keto Gummies offer many benefits, they are not a magical solution for weight loss. Remember that sustainable results come from a combination of healthy eating, regular exercise, and lifestyle changes.
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Are you looking for a natural and effective way to enhance your weight loss journey? Look no further than Reva Xtend Keto ACV Gummies! These gummies are packed with the power of apple cider vinegar (ACV) and other key ingredients that can help you reach your weight loss goals faster and more efficiently.
Boost Your Metabolism
One of the key benefits of Reva Xtend Keto ACV Gummies is their ability to boost your metabolism. ACV is known to increase the body’s metabolic rate, which can help you burn more calories throughout the day. By incorporating these gummies into your daily routine, you can supercharge your metabolism and enhance your body’s fat-burning capabilities.
Additionally, these gummies contain other ingredients like green tea extract and caffeine, which have been shown to further increase metabolism and promote weight loss. Together, these ingredients work synergistically to help you achieve your weight loss goals faster than ever before.
Suppress Your Appetite
Another benefit of Reva Xtend Keto ACV Gummies is their ability to suppress your appetite. ACV is known to help regulate blood sugar levels, which can prevent cravings and overeating. By taking these gummies regularly, you can feel fuller for longer periods of time and reduce your overall caloric intake.
Not only do these gummies help you eat less, but they also contain fiber, which can help promote feelings of fullness and satiety. This can be especially helpful for those who struggle with portion control or emotional eating, as it can help curb cravings and prevent unnecessary snacking.
Improve Your Digestion
In addition to aiding in weight loss, Reva Xtend Keto ACV Gummies can also improve your digestion. ACV is known for its ability to promote gut health and support digestion. By taking these gummies regularly, you can support a healthy digestive system and reduce bloating and indigestion.
These gummies also contain probiotics, which are beneficial bacteria that help maintain a healthy gut flora. By incorporating these probiotics into your diet, you can improve your overall gut health and promote optimal digestion and nutrient absorption.
Enhance Your Energy Levels
One of the side effects of weight loss can be a decrease in energy levels. However, Reva Xtend Keto ACV Gummies can help combat this issue by providing a natural energy boost. ACV is known to increase energy levels and reduce fatigue, which can help you stay motivated and active throughout the day.
Additionally, these gummies contain B vitamins, which are essential for converting food into energy. By including these vitamins in your daily routine, you can increase your energy levels and support your body’s natural energy production processes.
Maintain Blood Sugar Levels
People who struggle with their weight often have blood sugar imbalances. Reva Xtend Keto ACV Gummies can help maintain healthy blood sugar levels. ACV is known to help regulate glucose levels, which can prevent spikes and crashes in blood sugar.
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By incorporating these gummies into your routine, you can support stable blood sugar levels and prevent cravings and mood swings that are often associated with blood sugar imbalances. This can help you maintain a healthy weight and support your overall well-being.
Overall, Reva Xtend Keto ACV Gummies are a natural and effective way to enhance your weight loss journey. With their metabolism-boosting, appetite-suppressing, digestion-improving, energy-enhancing, and blood sugar-regulating properties, these gummies can help you achieve your weight loss goals faster and more efficiently.
Summary & FAQ
What are the key ingredients in Reva Xtend Keto ACV Gummies?
Reva Xtend Keto ACV Gummies contain apple cider vinegar, green tea extract, caffeine, fiber, probiotics, and B vitamins.
How should I take Reva Xtend Keto ACV Gummies?
For best results, take two gummies daily with a glass of water. Do not exceed the recommended dosage.
Are there any side effects of taking Reva Xtend Keto ACV Gummies?
While Reva Xtend Keto ACV Gummies are generally safe for most people, some individuals may experience mild digestive discomfort. If you experience any adverse reactions, discontinue use and consult a healthcare professional.
Where can I purchase Reva Xtend Keto ACV Gummies?
You can purchase Reva Xtend Keto ACV Gummies directly from the official website. Be cautious of buying from unauthorized sellers to ensure product quality and authenticity.
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