Study Shows Women with Heart Failure Lose More Weight on Semaglutide than Men

According to new research presented at the American Diabetes Association's 2024 Scientific Sessions and published in the Journal of the American College of Cardiology (JACC), Semaglutide, a medication initially developed for type 2 diabetes and obesity, significantly improves symptoms in men and women with a common type of heart failure that has had few therapeutic options. Women experienced greater weight loss and the same symptom benefits compared with men.

Obesity-related heart failure with preserved ejection fraction (HFpEF) is the most common type of HFpEF, and it is becoming a bigger problem worldwide, causing more illness and death.

Research shows that excess belly fat leads to changes in the body that contribute to both the development and worsening of heart failure, especially in women. People with obesity-related HFpEF have more severe heart failure symptoms, poorer functional status, a lower quality of life, and worse clinical outcomes compared to those without obesity. Therefore, there is an urgent need to develop effective and safe treatments specifically designed for obesity-related heart failure.

For the study, researchers analyzed the effects of semaglutide 2.4 mg, given once weekly, compared to placebo on various outcomes in the Semaglutide Treatment Effect in People with Obesity and HFpEF program. They evaluated 1,145 participants over 52 weeks, including 570 women.

The results revealed that:

1. Women lost 9.6% of their body weight on average with semaglutide, compared with 7.2% in men, marking a significant difference.

2. Both sexes saw notable improvements in HF symptoms, physical limitations, and exercise function.

3. At the start of the study, women had higher left ventricular ejection fractions, worse symptoms and physical limitations, and higher inflammation levels than men. Despite having higher BMIs, women had similar rates of hypertension and diuretic use and less atrial fibrillation compared to men.

“Understanding the sex differences in obesity-related HFpEF is of great importance. Obesity and visceral adiposity are key drivers of HFpEF development and progression, and this may be even more amplified in women, who represent the majority of people with the disease and bear a heavier burden of symptoms and physical limitations due to HFpEF. Our study sheds light on these differences and the consistent benefits of semaglutide for women and men,” said Mikhail Kosiborod, senior author of the study.

Reference: Subodh Verma, Mikhail N. Kosiborod, et al.; Efficacy of Semaglutide by Sex in Obesity-Related Heart Failure With Preserved Ejection Fraction: STEP-HFpEF Trials; Journal of the American College of Cardiology; 2024; https://doi.org/10.1016/j.jacc.2024.06.001.