By Annette Pinder

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are a class of medications originally developed to treat type 2 diabetes. Today, they are commonly used for weight management and are increasingly valued for their potential benefits to heart health. According to a comprehensive analysis published in Circulation, multiple large cardiovascular outcome trials have shown that GLP-1 receptor agonists offer a “robust and consistent reduction in atherothrombotic events,” including heart attack and stroke—especially in people with type 2 diabetes and other cardiovascular risk factors.

One of the most important studies, the SELECT trial, reported by The BMJ and The Lancet, showed that semaglutide reduced the risk of major adverse cardiovascular events (MACE)—such as heart attack, stroke, or cardiovascular death—by about 20% in adults who were overweight or obese and had existing cardiovascular disease, even if they did not have diabetes.

Additional evidence supports these findings. A meta-analysis published in BMC Cardiovascular Disorders concluded that semaglutide and similar GLP-1 medications provide significant cardiovascular benefits in randomized controlled trials. Broader analyses of GLP-1 drugs have also consistently shown reductions in cardiovascular death, stroke, and all-cause mortality compared to placebo.

Regulatory agencies have taken notice. In 2024, the U.S. Food and Drug Administration approved Wegovy as the first weight-loss medication with a specific cardiovascular indication for adults with overweight or obesity and established heart disease, reflecting strong confidence in the evidence.

Why Might GLP-1 Medications Benefit the Heart?

Researchers believe GLP-1 medications work in multiple ways. Reviews published in PMC Central show that these drugs improve common heart risk factors, including body weight, blood pressure, and cholesterol levels. They may also reduce inflammation and decrease plaque buildup in blood vessels, providing heart protection beyond weight loss alone. Real-world data further support this. Researchers at Mass General Brigham report that medications like semaglutide and tirzepatide could offer heart benefits that begin early in treatment.

How Common Are GLP-1s in the U.S.?

The use of these medications has grown rapidly. According to the Kaiser Family Foundation, about one in eight U.S. adults—roughly 12%—are currently using a GLP-1 medication for weight loss, diabetes, or other health issues. Other estimates suggest that tens of millions of Americans have tried a GLP-1 at some point.

Who May Benefit Most?

GLP-1 medications can be especially helpful for adults who are obese or overweight, people with type 2 diabetes, individuals with established cardiovascular disease, and those with multiple heart risk factors such as high blood pressure and high cholesterol. Medical experts say these medications can be powerful tools for reducing cardiovascular risk, but they work best when combined with lifestyle changes such as healthy eating, physical activity, and stress management. Highlighting the fact that GLP-1 medications improve blood pressure, cholesterol, and other contributors to heart disease when used appropriately under medical supervision,

Dr. Vijay Iyer, Chief of the Division of Cardiovascular Medicine for UBMD Internal Medicine, says, “There’s no question that these drugs lower the risks for cardiac disease, but they should be taken only after consultation with an individual’s physician.”