Do GLP-1s Have a Cardiovascular Benefit?

The question of whether semaglutide or other GlP-1’s such as Mounjaro, drugs primarily known for their efficacy in treating type 2 diabetes and weight loss, offers cardiovascular benefits to non-diabetic patients has been addressed by a groundbreaking study presented recently. This study, known as the SELECT trial, provides compelling evidence that semaglutide does indeed have significant cardiovascular benefits.

The SELECT trial, the largest ever conducted by Danish pharmaceutical giant Novo Nordisk, is a multicenter, double-blind, randomised, placebo-controlled study. This extensive trial involved over 17,000 participants from 41 countries and spanned five years, from October 2018 to March 2021.

Participants in the trial were 45 years or older, had a Body Mass Index (BMI) of 27 or greater, and had preexisting cardiovascular disease but no history of diabetes. They were randomly assigned to receive either a 2.4mg dose of semaglutide once per week or a placebo*. 

The findings of the SELECT trial are significant and indicate that semaglutide can substantially reduce the risk of serious cardiovascular events in non-diabetic patients. Here are the key results:

• Overall Cardiovascular Risk: Patients taking semaglutide experienced a 20% reduction in the overall risk of a cardiovascular event compared to those on the placebo.
• Heart Attack: The risk of a non-fatal heart attack dropped by 28% for those on semaglutide.
• Stroke: There was a 7% reduction in the risk of non-fatal stroke among the semaglutide group.

Beyond cardiovascular outcomes, semaglutide showed several other health benefits:

• Weight Loss: Participants on semaglutide lost an average of 9.39% of their body weight, significantly more than the less than 1% weight loss seen in the placebo group.
• Blood Pressure and Cholesterol: Improvements were noted in blood pressure and cholesterol levels among those taking semaglutide.
• A1C Levels: Although none of the participants had diabetes, semaglutide also improved A1C levels, indicating better blood sugar control.

The SELECT trial's findings highlight the cardiovascular benefits of semaglutide in non-diabetic patients, marking a significant advancement in cardiovascular therapy. As research continues, semaglutide may become a key player in the prevention of cardiovascular events, offering a new avenue for enhancing patient care and health outcomes.

* Placebo is a substance with no therapeutic effect, like a sugar pill, used in research to test if a medicine works by comparing its effects to those who didn't receive the actual medicine.