Therapeutic Potential of Metformin in Diabetes Mellitus-Related Cardiovascular Complications

Abstract

The diabetic population continues to grow worldwide, resulting in many chronic cardiovascular complications, including atherosclerosis and diabetic cardiomyopathy, as well as an increase in the incidence of heart failure. Metformin, as the first-line oral therapy for type 2 diabetes, lowers blood glucose and reduces the incidence of diabetes mellitus (DM)-related cardiovascular events, such as myocardial infarction. The cardiovascular protective effect of metformin is due not only to the relief of insulin resistance and the improvement of glucose and lipid metabolism but also to the inhibition of oxidation and inflammation. Metformin exerts its multiple effects primarily through AMPK-dependent and AMPK-independent mechanisms. This chapter reviews the beneficial effects of metformin on DM-related cardiovascular complications and dissects the potential molecular mechanisms.