Weight Loss Drug Wegovy Reduces Heart Attack and Stroke Risk by 20 Percent
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The weight-loss drug Wegovy reduces the risk of experiencing or dying from events like heart attacks and strokes by 20 percent in people with obesity and preexisting heart disease, according to results from a late-stage clinical trial published in The New England Journal of Medicine.
For the study, scientists randomly assigned 17,604 people with obesity and heart disease to receive weekly injections, of either a 2.4 milligram dose of Wegovy or a placebo, for almost three years on average. By the end of the study, 579 people on Wegovy died of cardiovascular causes or experienced things like heart failure, heart attacks, and strokes, compared with 701 people in the placebo group — meaning Wegovy reduced this risk by 20 percent.
“This is the first weight management therapy to show that it can reduce this risk on top of all of the other therapies patients take for cardiovascular disease,” says lead study author A. Michael Lincoff, MD, of the department of cardiovascular medicine at the Cleveland Clinic in Ohio.
Wegovy, like the type 2 diabetes drug Ozempic, contains the active ingredient semaglutide. These drugs are in a family of medicines known as glucagon-like peptide 1 (GLP-1) agonists, which work by mimicking the action of a hormone that makes people feel full.
Most patients in the study were taking aspirin as well as drugs known as statins, Lincoff says. Both of these medicines can help reduce the risk of heart attacks and strokes.
Wegovy Does More than Aid in Weight Loss
With Wegovy, people lost an average of 9.4 percent of their body weight by the end of the study. However, researchers saw improvements in several markers of cardiovascular risk like blood pressure, blood sugar, and inflammation soon after participants started taking the drug.
This suggests that the benefits of Wegovy come from both weight loss and from effects of the drug that are independent of how much weight people lose, says Robert Kushner, MD, a professor and director of the Center for Lifestyle Medicine at the Northwestern Feinberg School of Medicine who wasn’t involved in the new study.
“We know that weight loss improves multiple cardiovascular risk factors, such as high blood pressure, elevated blood sugar, and abnormal blood fats,” Dr. Kushner says. “In addition, semaglutide has weight independent effects such as reduced inflammation in the body, improved vascular tone and kidney function. The combination of these effects yields reduced cardiovascular events.”
One limitation of the study is that it only included people with preexisting cardiovascular disease. That means the results can’t explain whether Wegovy might prevent events like heart attacks or strokes in people without any history of cardiovascular disease.
“Wegovy is particularly valuable for patients with overweight and obesity with previous history of cardiovascular disease, but that does not imply that it is valuable for primary prevention of cardiovascular disease,” says Osama Hamdy, MD, PhD, medical director of the obesity clinical program at Joslin Diabetes Center and an associate professor at Harvard Medical School in Boston.
It would take a longer trial that includes patients with and without a history of cardiovascular disease to determine whether Wegovy might play a role in preventing this condition, says Dr. Hamdy, who wasn’t involved in the new study.
FDA Considering Approving Wegovy to Lower Heart Disease Risks
It’s also not clear from the study results whether Wegovy would be beneficial for preventing heart problems in people without overweight, obesity, or diabetes. Currently the drug is only approved for type 2 diabetes, or for people with overweight or obesity.
The U.S. Food and Drug Administration (FDA) is reviewing an added approval for Wegovy as treatment for reducing the risk of cardiovascular disease, and may issue a decision within six months, CNBC reported on November 2.
Another unanswered question from the study is whether patients with obesity and cardiovascular disease might get heart health benefits from another GLP-1 drug, Zepbound, which just won FDA approval for chronic weight management.
Zepbound, like the type 2 diabetes drug Mounjaro, contains the active ingredient tirzepatide. These drugs containing tirzepatide target two hormones — glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) — that are involved in maintaining healthy blood sugar levels and sending signals of satiety from the gut to the brain.
“I expect the cardiovascular results to be more impressive with the combined GLP-1 and GIP receptor agonists, not only because of the higher magnitude of weight loss by tirzepatide, but also because GIP receptor agonist has a potent effect on lipid profile,” Hamdy says, referring to cholesterol levels. Research is underway to assess the cardiovascular benefits of Zepbound, Hamdy adds.
“Right now, we have data to support the benefit of Wegovy in patients with obesity and previous history of cardiovascular disease, which is yet to be proven in response to Zepbound,” Hamdy says.
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