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Although empagliflozin appeared to have less of a reno-protective effect in patients with HFpEF than with HFrEF, further analyses of EMPEROR-Preserved indicate that this may be related to the endpoint definition used (which excluded renal death and included 40% decrease in eGFR), with positive findings when using the renal endpoint from the DAPA-HF trial (which included renal death and 50% decrease in eGFR) [130, 131]

This action elevates circulating IGF-1 levels and enhances cellular repair, metabolism, and tissue regeneration without direct hormonal supplementation

This is particularly important in aged animals, where oxidative stress is typically higher due to accumulated cellular damage over time