Jardiance for Heart Failure: How This Medication Supports Heart Health

Heart failure is a universal and devastating condition that affects millions of people throughout the world. It happens when the heart does not perform well, like when it cannot pump blood efficiently. Signs like fatigue, shortness of breath, and fluid retention are highlighted. Lifestyle changes, medications, and sometimes medical interventions are all traditional treatments for heart failure. A breakthrough medication, Jardiance (empagliflozin), which was originally developed for type 2 diabetes, also manages heart failure. This in-depth article will guide you through how Jardiance supports heart health, its mechanisms of action, benefits, prescribed dosage, and answers to frequently asked questions.

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Understanding Heart Failure

Heart failure is a condition where muscle fails to pump blood, also a chronic condition. Some conditions may contribute to it like coronary artery disease, hypertension, or previous heart attacks. To manage heart failure address all the underlying causes, relieving symptoms and improving heart function.

Types of Heart Failure:

1. Systolic Heart Failure (HFrEF): The heart cannot pump blood effectively when the ejection fraction gets reduced.
2. Diastolic Heart Failure (HFpEF): Stiff heart muscles cannot relax properly, reducing their ability to fill with blood.
3. Right-Sided Heart Failure: Legs and abdomen swell because blood backs up into the veins.
4. Left-Sided Heart Failure: Shortness of breath happens when fluid builds up in the lungs.

Symptoms of Heart Failure:

• Shortness of breath
• Fatigue and weakness
• Swelling in legs, ankles, and feet
• Rapid or irregular heartbeat
• Reduced ability to exercise
• Persistent cough or wheezing
• Increased need to urinate at night
• Swelling of the abdomen
• Rapid weight gain from fluid retention
• Lack of appetite and nausea
• Difficulty concentrating

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Jardiance: A Brief Overview

Jardiance is an SGLT2, inhibitor prescribed initially for managing type 2 diabetes. It starts work by reabsorbing glucose in the kidneys, thereby lowering blood sugar levels. Some clinical trials have revealed that it also provides significant cardiovascular advantages, making it a more valuable treatment for heart failure patients.

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How Does Jardiance Help Heart Failure?

1. Diuretic Effect

Jardiance promotes the excretion of excess fluid from the body by increasing glucose and sodium excretion in the urine. This diuretic effect reduces the volume of fluid the heart needs to pump, easing its workload and alleviating heart failure symptoms.

2. Improved Cardiac Function

Jardiance has been shown to enhance the overall function of the heart. It reduces the size of the heart and increases its efficiency, enabling better blood circulation and oxygen delivery to vital organs.

3. Reduced Oxidative Stress

Oxidative stress can damage heart tissues and contribute to heart failure progression. Jardiance helps reduce oxidative stress, protecting heart cells and improving overall heart health.

4. Anti-inflammatory Properties

Chronic inflammation plays a significant role in the development and progression of heart failure. Jardiance exhibits anti-inflammatory effects, reducing inflammation in heart tissues and supporting heart health.

5. Enhanced Energy Utilization

Jardiance promotes the utilization of ketones, an alternative energy source for the heart. This metabolic shift improves the energy efficiency of heart cells, helping them function better under stress.

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How Does Jardiance Work for Heart Failure?

The exact mechanism of action of Jardiance in heart failure is multifaceted and involves several pathways:

1. Sodium-Glucose Co-Transporter 2 (SGLT2) Inhibition

Jardiance decreases glucose reabsorption, by inhibiting SGLT2 in the kidneys, also leading to increased glucose excretion in the urine. This procedure also boosts sodium excretion, which has a double effect, reducing blood volume and pressure.

2. Hemodynamic Effects

Jardiance recovers hemodynamics by reducing the volume of blood in the ventricles at the end of diastole (preload) and the resistance the heart must overcome to eject blood (afterload). This outcome improves cardiac output and decreases strain on the heart.

3. Modulation of Neurohormonal Systems

Jardiance modifies neurohormonal systems counting in heart failure, such as the renin-angiotensin-aldosterone system (RAAS) and the sympathetic nervous system. All these systems play significant roles in blood pressure regulation and fluid balance, and their deregulation contributes to heart failure progression.

4. Metabolic Effects

Jardiance moves the heart’s metabolism to using ketones as an energy source as an alternative to glucose and fatty acids. Ketones are more energy-efficient and give fewer reactive oxygen species, thereby defending the heart from oxidative stress.

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Jardiance Heart Benefits

1. Reduction in Hospitalization

Some clinical trials found that Jardiance significantly decreases the risk of hospitalization because of heart failure exacerbations.  This advantage is significant to progress the quality of life and decreases the healthcare costs for heart failure patients.

2. Lowering Cardiovascular Death Risk

Jardiance associated with reduced risk of cardiovascular death in heart failure patients. This advantage extends to those with or without diabetes highlighting its wider applicability.

3. Symptom Relief

Some patients who use it frequently reported improvements in heart failure signs and symptoms like shortness of breath, edema, and fatigue. This progress contributes to better daily functioning and overall well-being.

4. Improved Exercise Capacity

By promoting cardiac function and decreasing symptoms, Jardiance helps to improve exercise ability in heart failure patients. This advantage is important for maintaining physical fitness and avoiding further deterioration.

5. Renal Protection

Jardiance also gives renal protective effects, which is important as kidney function frequently deteriorates in heart failure patients. By progressing in kidney function, Jardiance helps in monitoring the overall health of heart failure patients.

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Jardiance for Heart Failure without Diabetes

One of the most significant findings regarding Jardiance is its efficacy in treating heart failure patients without diabetes. This revelation has expanded the therapeutic options for non-diabetic heart failure patients, offering them a medication that can improve their heart health and overall prognosis. Clinical trials have demonstrated that the benefits of Jardiance in heart failure are not solely dependent on its glucose-lowering effects but also on its cardiovascular protective properties.

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Recommended Dose of Jardiance for Heart Failure

The recommended starting dose of Jardiance for heart failure is typically 10 mg once daily. Depending on the patient’s response and tolerance, the dose may be increased to 25 mg once daily. Patients need to follow their healthcare provider’s instructions and undergo regular monitoring to ensure optimal efficacy and safety.

Dose Adjustments:

• Renal Impairment: Dosage adjustments may be required for patients with renal impairment. Close monitoring of renal function is advised.
• Hepatic Impairment: Jardiance is not recommended for patients with severe hepatic impairment.
• Elderly Patients: No specific dose adjustment is needed, but monitoring is essential due to the higher likelihood of renal function decline with age.

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Clinical Trials and Evidence

1. EMPA-REG OUTCOME Trial

This landmark trial demonstrated that Jardiance significantly reduced the risk of cardiovascular death and hospitalization for heart failure in patients with type 2 diabetes and established cardiovascular disease.

2. EMPEROR-Reduced and EMPEROR-Preserved Trials

These trials extended the benefits of Jardiance to heart failure patients with reduced and preserved ejection fraction, respectively. Both trials showed a significant reduction in the risk of hospitalization for heart failure.

3. DAPA-HF Trial

Though primarily investigating dapagliflozin, a similar SGLT2 inhibitor, this trial’s findings support the class effect of SGLT2 inhibitors, including Jardiance, in reducing heart failure hospitalization and improving outcomes in heart failure patients, regardless of diabetes status.

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Mechanism of Action in Detail

1. SGLT2 Inhibition

Jardiance inhibits the SGLT2 transporter in the proximal tubule of the kidney, reducing glucose reabsorption and increasing urinary glucose excretion. This action also results in natriuresis (excretion of sodium), which contributes to its diuretic effect.

2. Hemodynamic Benefits

By reducing preload and afterload, Jardiance improves cardiac output. The reduction in blood volume and pressure decreases the workload on the heart, enhancing its efficiency and function.

3. Anti-inflammatory and Antioxidant Effects

Jardiance reduces markers of inflammation and oxidative stress, protecting heart tissues from damage and supporting better heart function.

4. Metabolic Shifts

Jardiance promotes a metabolic shift towards ketone utilization. Ketones are a more efficient energy source for the heart, especially under stress, providing a more stable and less damaging energy supply.

5. Neurohormonal Modulation

Jardiance impacts the RAAS and sympathetic nervous system, both of which are often overactive in heart failure. By modulating these systems, Jardiance helps in better fluid and blood pressure regulation.

 

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Frequently Asked Questions

How does Jardiance help with heart failure?

Jardiance relieves heart failure by decreasing fluid overload by diuretic effect, progressing cardiac function, reducing oxidative stress and inflammation, and promoting energy utilization in heart cells.

What are the heart benefits of Jardiance?

It offers multiple heart benefits, including reduced chances of hospitalization of heart failure, lower cardiovascular death risk, signs of relief, and improved exercise ability.

Can Jardiance be used for heart failure without diabetes?

Yes, patients with heart failure without diabetes can also use Jardiance. Some clinical trials have shown its efficacy in progressing heart health for both diabetic and non-diabetic heart failure patients.

What is the recommended dose of Jardiance for heart failure?

The starting dose is about 10mg per day, but it can be increased to 25mg based on the patient’s ability, response, and tolerance. Regular follow-ups and monitoring and following all the prescriptions which are prescribed by healthcare professionals.

How does Jardiance work in treating heart failure?

Jardiance has multiple mechanisms to work, including SGLT2 inhibition, hemodynamic progress, anti-inflammatory and antioxidant effects, metabolic shifts, and neurohormonal modification.

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Conclusion

Jardiance has developed as a groundbreaking medication for heart failure, giving hope and a progressive quality of life to millions of patients. Its multiple mechanisms provide important heart advantages, from decreasing the chances of hospitalization to promoting cardiac function and symptom relief. Either with or without diabetes, Jardiance shows promising advancements in the technology of heart failure management. As research reveals, Jardiance’s role in supporting heart health is poised to expand, introducing new possibilities for those fighting heart failure.

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References:

1. Empagliflozin (Jardiance) [Internet]. Nih.gov. Canadian Agency for Drugs and Technologies in Health; 2022 [cited 2024 Aug 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK602700/
2. Hao Z, Zhang Y. Different Doses of Empagliflozin in Patients with Heart Failure with Reduced Ejection Fraction. International Heart Journal [Internet]. 2022 Sep 30 [cited 2024 Aug 4];63(5):852–6. Available from: https://pubmed.ncbi.nlm.nih.gov/36104235/
3. ‌Faiez Zannad, Macari S. Drug treatment with empagliflozin lowered risk for hospitalization in people with heart failure with reduced ejection fraction: plain language summary of the EMPEROR-Reduced study. Future Cardiology [Internet]. 2023 Nov 9 [cited 2024 Aug 4]; Available from: https://pubmed.ncbi.nlm.nih.gov/37942680/
4. ‌Laurent Fauchier, Lamblin N, Tardu J, Bellier L, Harinala Groyer, Ittah D, et al. Public Health Impact and Cost-Effectiveness of Empagliflozin (JARDIANCE®) in the Treatment of Patients with Heart Failure with Preserved Ejection Fraction in France, Based on the EMPEROR-Preserved Clinical Trial. PharmacoEconomics – Open [Internet]. 2023 Aug 22 [cited 2024 Aug 4]; Available from: https://pubmed.ncbi.nlm.nih.gov/37606866/
5. Clinical Review [Internet]. Nih.gov. Canadian Agency for Drugs and Technologies in Health; 2023 [cited 2024 Aug 4]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK601683/

 

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 Dr.Marcella Jiovanni

Health and Beauty Expert

“Marcella Jiovanni actively promotes the importance of maintaining healthy skin, she envisions the future of dermatology as moving away from pure medical, pharmacological dermatology and flowing more toward a holistic approach to wellness and skincare.”