Weight loss jabs may help prevent heart attacks and strokes – regardless of how much fat people lose while taking the drug.
Being overweight can drastically increase the risk of heart related problems. Extra weight can lead to fatty material building up in the arteries – increasing the risk of high blood pressure, high cholesterol and heart disease.
But in the study led by University College London (UCL) researchers suggested there are multiple ways weight-loss drugs benefit the heart that are not due solely to losing fat.
Experts set out to examine the additional benefits of semaglutide, which is the main ingredient of Wegovy and also type 2 diabetes drug Ozempic.
“It is labelled as a weight loss jab but its benefits for the heart are not directly related to the amount of weight lost – in fact, it is a drug that directly affects heart disease and other diseases of ageing,” lead author Professor John Deanfield, from UCL’s Institute of Cardiovascular Science, said.
The study, published in the Lancet journal and funded by Danish drug company Novo Nordisk, looked at data from 17,604 people aged 45 and over who were overweight and had cardiovascular disease, but not diabetes.
Half of the people taking part in the study – which was spread over 41 countries – were given weekly injections of semaglutide with the other half given a placebo.
Previous analysis of the data found that semaglutide reduced the risk of major adverse cardiac events by 20 per cent.
Now researchers have confirmed that the benefit was apparent regardless of how much weight people lost while taking the drug.
People classed as overweight, with a body mass index (BMI) of 27, saw a similar benefit as those who had the highest BMI scores in the obese category. Plus, the benefits were mostly independent of how much weight people lost in the first four months of treatment.
However, the researchers found a link between shrinking waistlines, measured by waist circumference, and heart benefits, with this accounting for a third of the drug’s protective effect on the heart after two years.
“Abdominal fat is more dangerous for our cardiovascular health than overall weight and therefore it is not surprising to see a link between reduction in waist size and cardiovascular benefit. However, this still leaves two thirds of the heart benefits of semaglutide unexplained,” Prof Deanfield said.
“This work has implications for how semaglutide is used in clinical practice.”
“You don’t have to lose a lot of weight and you don’t need a high BMI to gain cardiovascular benefit,” he added.
“If your aim is to reduce cardiovascular disease, restricting its use to a limited time only and for those with the highest BMIs doesn’t make sense.
“At the same time, the benefits need to be weighed against potential side effects. Investigations of side effects become especially important given the broad range of people this medicine and others like it could help.”
Although the findings focus on semaglutide, they are likely to apply to other weight loss drugs that mimic GLP-1, the natural hormone which regulates blood sugar, appetite and digestion.
Researchers say these types of drugs could support the health of the lining of blood vessels, reduce inflammation, improve blood pressure and cholesterol.
Commenting on the study Naveed Sattar, professor of cardiometabolic medicine, suggested weight loss jabs could have an effect on tissues that slow development of plaques that cause heart disease.
“This fits with what we know from other trials of GLP-1RAs in people with diabetes where similar benefits were seen even when weight loss was minimal,” Prof Sattar told the Independent.
“This means these drugs both help people lose weight and have direct benefits independent of weight loss on the heart, sugar levels and potentially on the kidneys. Hence, they are being increasingly adopted in many specialities including cardiology,” he added.
Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation and consultant cardiologist, said: “These intriguing results demonstrate that the benefits of medications like semaglutide on heart health go beyond weight loss alone.
“But this leaves much unexplained. More research will be needed to unravel the other mechanisms of action behind the cardiovascular benefits beyond weight and fat loss, such as improvements in blood vessel health, control of blood pressure and blood sugar, or inflammation.
“While this is a very large study which followed patients for a long time, we can’t yet know the potential impact of sustained use of medications like these, especially in cardiovascular patients who are not living with overweight and obesity.”
The NHS in England is rolling out weight loss jabs to 240,000 people with the highest need over the next three years.
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