A new trial has found that semaglutide cuts cardiovascular events by 20% in people with obesity or overweight and cardiovascular disease but without diabetes.
The team behind the findings say it “marks the first pharmacologic intervention for overweight or obesity that’s been shown in a rigorous fashion to reduce the risk of cardiovascular events”.
The drug is normally given to adults with type 2 diabetes but can also be prescribed to help with weight loss in adults with obesity or overweight and at least one other health condition.
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This latest study showed that participants on average, lost 9.4% of their body weight after being treated with semaglutide. They also saw improvements in other cardiovascular disease risk factors.
Lead author Dr Michael Lincoff, vice chair for research in Cleveland Clinic’s Department of Cardiovascular Medicine, said: “It is known that overweight and obesity increase a person’s risk of cardiovascular events.
“Yet while reducing cardiovascular disease by treating high cholesterol, high blood pressure, and diabetes is standard practice, the concept of treating obesity to reduce cardiovascular complications has been hampered by the lack of evidence that lifestyle or pharmacologic interventions for overweight or obesity improve cardiovascular outcomes.”
It is predicted that by 2035, more than half of the world’s population will have obesity or overweight. Around four million deaths around the world in 2015 were attributed to high BMI, with cardiovascular diseases accounting for more than two thirds of the deaths.
Semaglutide, which works by supressing appetite, may reduce cardiovascular risk through its other actions, such as improving glucose levels, reducing blood pressure, cholesterol and inflammation. It may also have a positive impact on heart muscle and blood vessels.
Dr Lincoff said: “There’s growing recognition that obesity and overweight are really metabolic diseases, and yet, effective therapies have been quite limited.
“This study of semaglutide demonstrates the effectiveness of a new pathway to reduce the excess risk associated with obesity of important and potentially deadly cardiovascular complications.”
The study, which involved more than 17,000 people across 41 countries, ran from October 2018 to June 2023.
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The participants were all aged 45 or over with pre-existing cardiovascular disease and a BMI of 27 or higher, but who did not have diabetes.
They received weekly injections of semaglutide or placebo and were followed by the research team for an average of 40 months.
All the participants received standard treatment for cardiovascular disease, such as beta blockers and cholesterol medications.
The findings showed that in the semaglutide group, 6.5% of patients experienced a non-fatal heart attack, non-fatal stroke or died from a cardiovascular event. The figure for the placebo group was 8%.
A limitation of the study was that people without previous cardiovascular disease were not included.
Read the study in the New England Journal of Medicine.
