Verapamil: prevention and treatment of cardio-renal syndromes in diabetic hypertensive patients?

Patients with diabetes mellitus (DM) often present other chronic comorbidi-ties including arterial hypertension (AH), chron-ic kidney disease (CKD), ischemic heart dis-ease (IHD) and heart failure with preserved ejec-tion fraction (HFpEF). The frequent association of the latter conditions is considered part of the spectrum of cardio-renal syndromes (CRS), a group of disorders of the heart and kidneys whereby acute or chronic dysfunction in one or-gan may induce acute or chronic dysfunction of the other. Verapamil is a non-dihydropyridine calcium channel blocker (CCB) widely used in the treatment of hypertension, chronic stable angina, secondary prevention of reinfarction, paroxysmal supra-ventricular tachycardia and for rate control in atrial fibrillation/flutter. In ad-dition to its antihypertensive and anti-ischemic actions verapamil exerts favorable effects al -so on glycemic control, proteinuric diabetic ne-phropathy, left ventricular diastolic dysfunction and sympathetic nervous system overactivity which may potentially benefit patients with DM and CRS. In this narrative review, we summarize the current evidence on the potential role of ve-rapamil in the prevention and treatment of CRS in diabetic hypertensive patients.