Could Ozempic prevent heart attack and stroke?

In this article:

• Ozempic and heart disease
• Candidates for semaglutide
• Future of semaglutide for CVD
• The bottom line

In this article

• Ozempic and heart disease
• Candidates for semaglutide
• Future of semaglutide for CVD
• The bottom line

In a world where the battle against obesity and diabetes is more pressing than ever, a groundbreaking medication is making waves for its dual capabilities. Ozempic (active ingredient semaglutide), a prescription medication manufactured by Novo Nordisk, is approved by the U.S. Food and Drug Administration (FDA) to help control blood sugar in patients with Type 2 diabetes. Ozempic has also shown promise as a weight-loss medication and is often prescribed off-label for this purpose.

Wegovy, another brand name formulation of semaglutide, is FDA-approved for weight management in obese individuals with a body mass index (BMI) over 30 or overweight individuals with a BMI over 27, and at least one weight-related health condition, including high cholesterol, Type 2 diabetes, and high blood pressure.

A glucagon-like peptide-1 receptor agonist, semaglutide, mimics the action of a natural hormone called GLP-1, reducing blood sugar levels by stimulating insulin secretion and reducing glucagon secretion. GLP-1 receptor agonists also help with weight loss by delaying gastric emptying and reducing appetite.

Another exciting effect of GLP-1s is their potential to reduce the risk of major adverse cardiovascular events like heart attack and stroke. In fact, Wegovy recently received FDA approval to prevent serious cardiovascular events like heart attack and stroke in adults with obesity or who are overweight. Keep reading to learn how semaglutide and other GLP-1s improve cardiovascular risk factors.

How semaglutide may improve cardiovascular health

How exactly do GLP-1 receptor agonists like Ozempic enhance cardiovascular health? According to Yu-Ming Ni, MD, a board-certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in Fountain Valley, California, they promote weight loss, a significant factor in reducing cardiovascular risk.

“With Wegovy and Ozempic, we’re seeing an average 10% reduction in weight taken over the course of a year or so,” says Dr. Ni, adding that with Mounjaro and Zepbound (active ingredient tirzepatide), a dual GIP [glucose-dependent insulinotropic polypeptide] and GLP-1 receptor agonist) are even more effective weight-loss drugs. He explains that as a result, these medications have shown several heart health benefits, including lower cholesterol levels, reduced blood pressure, and improved overall heart function—risk factors that precipitate cardiovascular disease (CVD).

Hosam Hmoud, MD, a cardiology fellow at Northwell’s Lenox Hill Hospital in New York, says semaglutide also has an important anti-inflammatory component that helps improve outcomes in patients with cardiovascular disease, such as heart failure, coronary artery disease (CAD), and stroke. Inflammation is a risk factor for cardiovascular disease, irritating blood vessels, promoting plaque build-up, and increasing the risk of blood clots.

Dr. Hmoud emphasizes that weight loss and blood pressure are proportionally related—even a small increase in weight can increase blood pressure. “The better weight loss you achieve, the better your blood pressure is controlled—and that affects all of the organs in your body, from your heart to your brain to your kidneys,” says Dr. Hmoud.

Studies have demonstrated the efficacy of semaglutide for cardiovascular indications. For example, the 2016 SUSTAIN-6 trial tested the cardiovascular safety of semaglutide in patients with Type 2 diabetes who had established cardiovascular diseases or were at high risk. To qualify, patients needed to be at least 50 years old and have heart disease, chronic heart failure, or advanced kidney disease, or be at least 60 years old with at least one heart-related health risk. They were given once-weekly doses of semaglutide (0.5 mg or 1.0mg) or a placebo for 104 weeks. Results showed that semaglutide significantly reduced the risk of major adverse cardiovascular events (MACE), including death, nonfatal heart attack, and nonfatal stroke.

A new study, the STEP trial, examined semaglutide’s impact on cardiovascular outcomes in overweight people or people with obesity and established cardiovascular disease. Results indicated that semaglutide not only aids in weight loss but also improves cardiometabolic risk factors.

While Dr. Ni says semaglutide is generally safe for individuals with pre-existing heart conditions, patients need to discuss their specific health situations with their healthcare providers. Seek medical advice if you experience any concerning symptoms, such as heart palpitations, with semaglutide.

Who should take semaglutide for heart health? 

Semaglutide may be beneficial for patients with Type 2 diabetes who also have cardiovascular risk factors, such as hypertension or high cholesterol, says Dr. Hmoud. However, it should be prescribed as part of a comprehensive treatment plan tailored to the individual.

And while semaglutide can be an invaluable tool for managing weight and improving heart health, Dr. Ni recommends lifestyle changes like diet and exercise first. He says that individuals with certain pre-existing conditions should avoid taking semaglutide, including:

• Medullary thyroid carcinoma (MATC) or multiple endocrine neoplasia syndrome type 2 (MEN-2): Patients with a personal or family history of these conditions should avoid semaglutide, which may increase the risk of thyroid tumors.
• Allergic reactions: Individuals with a history of severe allergic reactions to semaglutide or other GLP-1s should avoid the medication.
• Severe gastrointestinal issues: Individuals with a history of severe gastrointestinal problems, such as gastroparesis or pancreatitis, should steer clear of this medication, as semaglutide can exacerbate these conditions.
• Pregnant or breastfeeding women: Individuals who are planning to become pregnant or are pregnant or breastfeeding should consult a healthcare professional before taking semaglutide, as its safety in these populations has not been established.
• Gallbladder or kidney disease: Semaglutide can cause gallbladder issues, including gallstones or acute kidney injury in certain instances.

Patients with cardiovascular disease who are obese or overweight with a comorbid health condition may benefit from treatment with semaglutide, says Dr. Hmoud. When prescribing the medication, cardiologists follow specific guidelines, such as:

• Considering cardiovascular risk factors: These include hypertension, high cholesterol, Type 2 diabetes, and a family history of heart disease.
• Monitoring for side effects: Patients starting semaglutide should be closely monitored for serious side effects, like:
  • Pain in the upper part or middle of the stomach that spreads to the back
  • Allergic reaction
  • Decreased urination and swelling of the feet, legs, or ankles
  • Changes in vision
  • Fainting or dizziness
  • Yellow eyes (jaundice), dark urine, or clay-colored stools
  • Rapid heartbeat
  • Sweating, confusion, drowsiness, headache, or blurred vision
• Customizing a treatment plan: Semaglutide should be tailored to each patient’s unique health profile, including their cardiovascular risk and comorbidities.

Could GLP-1s become the primary prevention for heart disease? 

Treatment for heart disease depends on the specific condition. ACE inhibitors and beta blockers are typical first-line treatments to prevent heart failure. Dr. Ni points out that while GLP-1s show potential in the prevention of heart disease, especially among individuals who are overweight and obese, more research is needed to establish definitive guidelines. 

Even so, establishing these medications as primary prevention measures for CVD presents challenges. For example, some patients may experience side effects that limit their usefulness. Or, their high cost may limit accessibility. If cost is an issue, SingleCare coupons can help you save on GLP-1s.

Ozempic coupons, Wegovy coupons, Mounjaro coupons, Zepbound coupons

While studies are currently being conducted, results must be obtained to solidify the role of GLP-1s in cardiovascular prevention. Drs. Ni and Hmoud emphasize the importance of comprehensive cardiovascular risk management, including lifestyle changes and other medications.

The bottom line

Semaglutide has shown significant potential in improving cardiovascular health and reducing the risk of heart attacks and strokes. However, it’s important to weigh the cardiovascular benefits of semaglutide against the potential risks and contraindications with your healthcare provider to ensure an effective approach to cardiovascular health.