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Insulin resistance as well as the hypertensive response can cause damage to the structural integrity and transport function of the bloodbrain barrier, increase the permeability of the bloodbrain barrier (24), and the entry of free fatty acids (FFA) and other plasma components into the brain tissue to disrupt the homeostatic balance of the brain, as well as the entry of immune cells and inflammatory factors in the peripheral circulation into the CNS, which can cause further neuronal damage, thus leading to cognitive dysfunction (19)

The detailed analysis of combining these medications reveals important considerations about side effect overlap, monitoring requirements, and clinical evidence gaps

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