New clinical data suggest that the weight-loss drug Wegovy can significantly reduce the risk of heart attacks and strokes even before patients experience substantial weight loss.
Wegovy, which contains the appetite-suppressing compound semaglutide, is available through the UK’s National Health Service (NHS) for individuals with a high body mass index (BMI) and is also sold privately. The drug’s manufacturer, Novo Nordisk, has released what it describes as “landmark” data indicating that Wegovy may offer cardiovascular protection early in the treatment process, significantly reducing the risk of heart attacks, strokes, and premature death in high-risk patients.
An analysis of clinical trial data shows that within the first three months of treatment, patients living with obesity and cardiovascular disease experienced a 37% reduction in the combined risk of heart attack, stroke, or cardiovascular-related death. After six months of treatment, the results were even more promising, with a 50% reduction in cardiovascular death and a marked decline in emergency treatments for heart failure.
The findings come from the SELECT trial, which involved 17,604 participants and demonstrated that Wegovy can deliver cardiac benefits even before patients achieve what is defined as clinically meaningful weight loss—typically a reduction of at least 5% of body weight.
Researchers say the heart-protective effects are not solely due to the drug’s weight-loss properties. Benefits were observed before patients reached the full 2.4mg maintenance dose of semaglutide, a glucagon-like peptide-1 (GLP-1) receptor agonist.
Professor Donna Ryan of the Pennington Biomedical Research Center in Louisiana, who participated in the study, said the cardiovascular improvements were “almost immediate,” occurring earlier than the timeframe typically associated with significant weight loss.
“This study is definitive proof that we can reduce cardiovascular events in people at high risk,” Prof Ryan said. “The drug’s effect appears before you expect to see any substantial weight loss, and even before patients reach the highest dose of semaglutide. The implication for clinicians is clear: we shouldn’t delay treatment for at-risk individuals—initiation should happen early.”
She added that, in her view, patients who have recently experienced a heart attack or stroke should be promptly started on the drug to maximize benefit.
Asked whether semaglutide should be used preventively in people who haven’t yet shown signs of heart disease, Prof Ryan emphasized the need for further evidence. “There’s a big gap between suggesting and proving,” she said. “It would require a much larger, longer, and more expensive trial to determine its preventive efficacy in lower-risk populations.”
Dr Jorge Plutzky, the lead author of the study and director of preventive cardiology at Brigham and Women’s Hospital at Harvard Medical School, noted that semaglutide 2.4mg is the only GLP-1 drug to demonstrate such rapid cardiovascular benefits.
“The benefits appeared within months, not years,” he said. “Our results reveal a separation in treatment outcomes that occurs early, even in the absence of major weight loss and before full semaglutide titration.”
Dr Plutzky added that more research is needed to identify the mechanisms driving these early benefits. Potential factors may include semaglutide’s ability to reduce inflammation, lower blood sugar and blood pressure, exert direct cardiovascular effects, influence early dietary changes, or act through a combination of these pathways.
The SELECT trial is a randomized, double-blind study comparing semaglutide 2.4mg to placebo for preventing heart attacks, strokes, and early death in overweight or obese individuals with established cardiovascular disease. All participants had previously experienced a heart attack, stroke, or had peripheral artery disease. Importantly, the majority were already receiving standard treatments for cholesterol and blood pressure, suggesting semaglutide’s effects were additive.
Novo Nordisk has reported a sharp rise in demand for Wegovy, as awareness of its heart-health benefits grows among healthcare providers and patients alike.
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