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Epigenetic and Cellular Reprogramming: By blocking NNMT-mediated methylation of nicotinamide, preserves NAD salvage pathway activity, increases SIRT-1 signaling, reduces histone deacetylation, and promotes metabolic reprogramming toward oxidative phosphorylation and glycolysis balance, supporting tissue repair and energy homeostasis 1-4

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In patients with HFpEF and obesity, both semaglutide (STEP-HFpEF) and tirzepatide (SUMMIT) significantly reduced cardiovascular death and worsening heart failure events, with concomitant improvements in quality of life and functional capacity [3,47]

Poor sleep disrupts hunger hormones, increases cortisol, and impairs insulin sensitivity