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The natural hormones are highly regulated, and they work in concert together, almost like an orchestra

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In diabetes, HFpEF is predominantly driven by coronary microvascular disease/dysfunction, systemic inflammation, as well as cardiovascular autonomic dysfunction (which is very specific to diabetes) and a deficient heart oxidative metabolism, all leading to remodeling of the heart and increased stiffness, while HFrEF is predominantly driven by adverse remodeling secondary to accelerated atherosclerotic CVD (ASCVD)

Crosstalk between glomeruli and tubules

For most medications, this delay is clinically insignificant