Semaglutide Study on Cardiovascular Disease

Heart disease is the leading cause of death in the United States4, and one of the greatest contributing factors to heart disease is obesity. With nearly 75% of the adult population considered overweight or obese, this puts much of the country at risk for heart disease. Though somewhat outdated, BMI remains the number one measurement for determining obesity. Using a formula based on height and weight, a BMI greater than 30 is obese, while a BMI between 25 and 29.9 is overweight.² We will discuss the pitfalls of such a formula to determine health in a future article, but it is the standard tool providers use today.

To combat diabetes and obesity, providers and patients are turning to prescription medications such as glucagon-like peptide-1 (GLP-1) receptor agonists. GLP-1 receptor agonist medications—like Ozempic, Rybelsus, and Wegovy—improve the body’s natural insulin production.³ Diabetic patients treated with these medications have found another side effect: weight loss. Semaglutide is available in daily oral doses (Rybelsus) and weekly injections (Ozempic and Wegovy) and may also be a key part of combating heart disease.

According to a recent SELECT trial6 by Novo Nordisk, the maker of Ozempic, Rybelsus, and Wegovy, semaglutide can potentially reduce cardiovascular disease risk. The study followed over 17,000 participants with a BMI of ≥ 27 without a history of diabetes. These patients were given once-weekly injections of semaglutide 2.4 mg. The results were stunning. Semaglutide was estimated to reduce heart disease risk by 18%, potentially preventing 1.5 million cardiovascular events over ten years.1

A healthy body requires a healthy lifestyle, so a balanced diet and exercise are essential. However, GLP-1 receptor agonist medications may aid in jumpstarting those results.

Risks

As with many treatment options, there are risks. The most common side effects of GLP-1 medications include nausea, vomiting, and diarrhea. This can lead to dehydration and acute kidney problems. Hypoglycemia is also possible, though less common. Some patients have reported gastroparesis and ideations of self-harm.

Aside from the gastrointestinal issues, the most limiting factor of semaglutide is cost. Monthly prescriptions cost almost $1,000.5. Because insurance coverage is based on several criteria, many patients must pay this large sum out-of-pocket.

Take-Away

Semaglutide is not a miracle but can improve patient outcomes when paired with a healthy diet and exercise. Besides helping treat diabetes and obesity, GLP-1 medications may lower the risk of heart disease. With possible health and financial risks, discussing the prescription of semaglutide with your provider is essential.

References

1. Wong ND, Karthikeyan H, Fan W. US Population Eligibility and Estimated Impact of Semaglutide Treatment on Obesity Prevalence and Cardiovascular Disease Events. Cardiovascular Drugs and Therapy. Published online August 14, 2023. doi:https://doi.org/10.1007/s10557-023-07488-3
2. Centers for Disease Control and Prevention. Defining Adult Overweight and Obesity. Centers for Disease Control and Prevention. Published 2021. https://www.cdc.gov/obesity/basics/adult-defining.html
3. Collins L, Costello RA. Glucagon-like Peptide-1 Receptor Agonists. PubMed. Published 2020. https://www.ncbi.nlm.nih.gov/books/NBK551568/
4. Centers for Disease Control and Prevention. Heart Disease and Stroke. www.cdc.gov. Published October 7, 2020. https://www.cdc.gov/chronicdisease/resources/publications/factsheets/heart-disease-stroke.htm#:~:text=Leading%20risk%20factors%20for%20heart
5. Hullett A. How to Get Semaglutide: Eligibility, Cost, Insurance, and More. Healthline. Published June 21, 2023. https://www.healthline.com/health/how-to-get-semaglutide#cost
6. Novo Nordisk. Novo Nordisk A/S: Semaglutide 2.4 mg reduces the risk of major adverse cardiovascular events by 20% in adults with overweight or obesity in the SELECT trial. GlobeNewswire News Room. Published August 8, 2023. Accessed August 25, 2023. https://www.globenewswire.com/news-release/2023/08/08/2720343/0/en/Novo-Nordisk-A-S-Semaglutide-2-4-mg-reduces-the-risk-of-major-adverse-cardiovascular-events-by-20-in-adults-with-overweight-or-obesity-in-the-SELECT-trial.html

Dr. Tordini is a part of Florida Medical Clinic Orlando Health