Weight-Loss Drug GLP-1 Could Cut Heart Disease Risk by a Fifth in Obese Adults
A new analysis projects that GLP-1 receptor agonists like semaglutide could prevent roughly one in five heart attacks and strokes among obese people without existing heart disease. The finding expands the potential market for these drugs beyond diabetes and obesity treatment into primary prevention—a shift that could reshape prescribing patterns and insurance coverage decisions.
Originaltitel: Emulated Effects of Glucagon-Like Peptide 1 Receptor Agonist Therapy in the General Population
BACKGROUND: Glucagon-like peptide-1 receptor agonists (GLP-1RAs) reduce cardiovascular risk in obese individuals with established cardiovascular disease (CVD), potentially through modulating key risk factors. However, their benefit in primary prevention remains unclear. OBJECTIVES: This study aims to emulate GLP-1RA use for primary prevention by applying risk factor changes observed in the SELECT (Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes) trial to obese individuals at risk of but without established CVD. METHODS: and a SCORE2 (Systematic Coronary Risk Evaluation 2)-derived baseline risk ≥7.5%. Secondary analyses examined nonobese and lower SCORE2 groups and accounted for reduced compliance. RESULTS: and a SCORE2-derived baseline risk ≥7.5%. Observed 10-year CVD incidence was 13.82% (95% CI: 11.94%-15.71%). Emulated GLP-1RA therapy lowered projected CVD incidence to 10.83% (95% CI: 9.27%-12.39%), an absolute reduction of 2.99% (95% CI: 2.67%-3.31%) and a relative reduction of 22%. Absolute reductions were larger in men than in women (3.14% [95% CI: 2.82%-3.47%] vs 2.7% [95% CI: 2.23%-3.16%]), with similar potential relative reductions across sexes (21% vs 23%). Modeled risk reductions were attenuated in nonobese and lower SCORE2 groups and diminished further with lower compliance assumptions. CONCLUSIONS: In appropriately selected individuals at high CVD risk, GLP-1RA therapy may complement existing primary prevention strategies, supporting the rationale for future randomized studies.