Semaglutide, the active ingredient in Wegovy and Ozempic, has long been considered a breakthrough in the fight against obesity. However, recent evidence has revealed that these drugs may also save the lives of patients with other health conditions, including heart disease, asthma, and even alcoholism.
In the largest and longest trial to date investigating the cardiovascular benefits of semaglutide, British researchers found that the drug's cardiac benefits were evident regardless of the amount of weight lost.
The trial was conducted in 41 countries, involving 17,604 patients at least 45 years old who were overweight or obese. Half of the participants received the highest dose of semaglutide (2.4 mg weekly), while the other half received a placebo.
The researchers found that patients with a BMI of 27 (meaning a person's weight is above ideal for their height, but not yet obese) "had similar benefits to those with a higher BMI," and that the benefits were largely independent of the amount of weight lost during the first four months of treatment.
The results showed that the amount of weight lost in the early stages did not predict who would benefit from reduced heart problems, while a reduced waist circumference—a marker of reduced belly fat—played a significant role, accounting for about a third of the drug's overall heart health benefits and reducing the risk of heart attacks and strokes by about 14%.
Professor John Denfield, a cardiologist at University College London and lead author of the study, said: "Belly fat is more dangerous for the heart than overall weight, so it's not surprising that reducing waist circumference is associated with heart benefits. However, two-thirds of the heart benefits of semaglutide remain unknown. Its heart benefits are not directly related to the amount of weight lost, but rather directly affect heart disease and other diseases of aging."
He added: "It is not necessary to lose a lot of weight to achieve heart benefits. If the goal is to reduce heart disease, then limiting the drug's use to a limited period or to people with the highest BMI does not make sense. The benefits must also be balanced against the potential side effects, especially given the large number of people who could benefit from the drug."
Professor Azim Majeed, a primary care expert at Imperial College London, said: "These findings reinforce the use of semaglutide as a preventative treatment for high-risk patients, not just as a weight-loss tool. This could expand the drug's use beyond BMI limits and encourage its early use in the prevention of heart disease."
The study was published in The Lancet.
