With the use of GLP-1 medications increasing, cardiologists are noting potential benefits for heart health that may extend beyond weight loss. GLP-1 drugs, such as semaglutide, were originally used to treat diabetes but are now also prescribed for weight management due to their effect on appetite and metabolism.
“It is known that maintaining a healthy weight is an important part of heart health. GLP-1 receptor agonists can help with achieving a healthy weight, which can be beneficial to the heart,” said Dr. Layla Abushamat, assistant professor of medicine at Baylor College of Medicine. “However, now there is emerging research that is looking into the heart-protective benefits of the drug itself, beyond weight loss.”
The American Heart Association has identified excess and dysfunctional fat tissue as a key factor in cardiovascular disease. According to Dr. Abushamat, “Adipose tissue is not passive; it functions as an endocrine organ, releasing hormones that communicate with the body, including the cardiovascular system.” Excess fat is linked to inflammation, insulin resistance, abnormal cholesterol levels, high blood pressure and metabolic syndrome—all factors that increase the risk of heart disease and stroke.
GLP-1 therapies address several of these risk factors by supporting weight loss, improving blood sugar control, lowering blood pressure and cholesterol levels, and reducing inflammation.
“There is a pivotal study called the SELECT Trial, published in 2023, that showed reduction in cardiovascular events in people with overweight or obesity and cardiovascular disease who took semaglutide,” Abushamat said.
The SELECT Trial involved adults with overweight or obesity and existing cardiovascular disease. Those treated with semaglutide had a 20% lower rate of major cardiovascular events compared to those who did not receive the drug. Further analysis indicated these benefits occurred regardless of participants’ starting weight or amount of weight lost.
“This potentially suggests that mechanisms beyond weight loss, such as reduction in inflammation or direct effects on the heart and blood vessels, may play a role,” Abushamat said.
Dr. Abushamat cautioned that GLP-1 therapies have side effects and should only be taken under medical supervision. Reported side effects include gastrointestinal issues, dehydration, electrolyte imbalances, muscle mass loss and increased heart rate. The medication is not recommended for individuals with certain conditions such as personal or family history of medullary thyroid cancer or during pregnancy; those with unexplained pancreatitis or severe gastrointestinal diseases require special caution.
“These are all factors that should be discussed with a doctor to find out if you are the right candidate for this type of medication,” she said.
While the body naturally produces GLP-1 after eating food, pharmaceutical versions act differently from natural forms produced in the gut. Dr. Abushamat warned against online products claiming to boost natural GLP-1: “Online prescriptions or products that claim to naturally produce GLP-1 are not the same as the pharmaceutical versions. Those also often do not include proper evaluations or follow-up visits with a doctor. These are not FDA-approved products and could pose significant risks.”
She added: “Claims of ‘natural GLP-1 boosters’ are unsupported by scientific evidence.”
Weight regain after stopping GLP-1 therapy remains an issue: “We do know that once you stop a GLP-1, there is a risk of weight regain. From the clinical trials, those who stopped these therapies regain around two-thirds of the weight that was lost, so focusing on weight loss maintenance is also important,” Abushamat said. “This is another reason why talking to your healthcare provider and being monitored by a healthcare provider when using this type of therapy is so important to overall reduction of cardiovascular illness.”
Baylor College of Medicine supports community service among its core missions while operating independently through various clinical partnerships (https://www.bcm.edu/news). The institution advances research and education across multiple schools while providing patient care via collaborations (https://www.bcm.edu/news). Since relocating to Houston’s Texas Medical Center in 1943 after its founding in 1900, Baylor College of Medicine has focused on developing integrated health sciences environments (https://www.bcm.edu/news). Paul Klotman serves as president, chief executive officer and executive dean at Baylor College of Medicine (https://www.bcm.edu/news).
