Semaglutide improves cardiovascular health in users in addition to causing weight loss: Study

Following a year of semaglutide (Wegovy) use, the patient's risk of a heart attack or stroke dropped to 6.3% from 7.6% over the next ten years, measured by a commonly used calculator.

The study was performed only among 93 patients, and researchers at the Mayo Clinic said, "More and larger studies were needed to see if the risk reduction score meant less illness and death long-term."

Obesity is a significant risk factor for developing type 2 diabetes mellitus (T2DM), dyslipidemia, obstructive sleep apnea, and hypertension (HTN). These comorbidities are associated with an elevated risk of CVD (cardiovascular disease), which represents the leading cause of mortality globally. Hence, there is a need for CVD prevention by targeting excess adiposity in patients with obesity or overweight.

Semaglutide, a glucagon-like peptide-1 receptor (GLP-1) agonist, is the recently approved anti-obesity medication whose cardiovascular impact in patients with and without T2DM is not well established. W. Ghusn from Mayo Clinic, Rochester, MN, and colleagues aimed to study the real-world effect of using semaglutide on CVD risk in patients with obesity or overweight.

For this purpose, the researchers performed a multicenter retrospective study of patients with a BMI (body-mass index)≥ 27 kg/m2, no prior history of CVD, and ages between 40-79 years. Baseline clinical, demographic, and lipid panel data were collected to calculate the 10-year ASCVD risk at baseline and one year after semaglutide initiation. The researchers used the 10-year ASCVD risk estimator the American College of Cardiology created.

The analysis included 93 patients (69% female, mean age 55.0± 8.1, mean BMI 39.8± 8.6 kg/m2). The primary endpoint was the difference in ASCVD score between baseline and one year after semaglutide initiation. Secondary outcomes included total body weight loss percentage (TBWL%) and change in HbA1c, blood pressure, lipid panel, fasting glucose, statin and aspirin use, and hypertension medications between baseline and last follow-up.

The authors reported the following findings:

• There was a significant decrease in the 10-year ASCVD risk between baseline and one year: 7.6% versus 6.3% (Figure 1A).
• The following parameters decreased significantly: blood pressure by 9.3/4.9 mmHg (n= 93), total cholesterol by 9.5 mg/dL (n=93); LDL by 6.6 mg/dL (n=93), triglycerides by 20.0 mg/dL (n=93), fasting glucose by 23.0 mg/dL (n= 64), and HbA1c by 0.72% (n=54).
• There was no significant change in the use of hypertension medications, aspirin and statins between baseline and last follow-up.
• The TBWL% associated with semaglutide use at 12 months was 10.9% (n=41).

Semaglutide users experienced declines in total cholesterol, blood pressure, blood sugar levels, and triglycerides.

"Semaglutide use in overweight/obese patients is associated with a reduction in the 10-year ASCVD risk; the decrease may translate into decreased cardiovascular mortality and morbidity risks," the researchers wrote. "More studies are needed, with larger sample sizes and longer follow-up periods, to assess the cardiovascular outcomes of semaglutide."

Reference:

The study "Cardiovascular Risk Improvement with Semaglutide in Patients with Overweight and Obesity: A Multi-centered Study" was presented at the European Congress on Obesity in Dublin, Ireland.