- Researchers report that the weight loss drugs semaglutide and tirzepatide can reduce the risk of hospitalization and death by 40% in people with a common type of heart failure.
- Experts say this large cohort study strengthens the case for using these GLP-1 medications in people with this heart condition.
- Regular exercise, a balanced diet, and quality sleep are important in maintaining good heart health.
Two widely used weight loss drugs could significantly reduce the risk of complications in people with the most common type of heart failure
The findings show that semaglutide, commonly sold under the brand names Ozempic, Wegovy, and Rybelsus, produced similar benefits to those produced by tirzepatide, commonly sold under the brand names Zepbound and Mounjaro.
Semaglutide and tirzepatide reduced the risk of hospitalization for HFpEF and all-cause mortality by 40% compared to subjects who took the blood sugar medication sitagliptin, commonly sold under the brand name Januvia.
The researchers looked at five cohort studies that used data from healthcare claims in the United States between 2018 and 2024. Eligibility criteria were then expanded to evaluate treatment effects in patients typically treated in clinical practice. Finally, a head-to-head comparison of tirzepatide and semaglutide was implemented with a follow-up of 52 weeks.
In all, the researchers examined 58,000 people in a semaglutide versus sitagliptin comparison. Another 11,000 people were in a group that compared tirzepatide and sitagliptin, while 28,000 patients were studied in a semaglutide versus tirzepatide comparison.
“These findings complement early results from small clinical trials and support the use of semaglutide and tirzepatide in patients with cardiometabolic heart failure with preserved ejection fraction,” the authors wrote.
“This study further strengthens the case for using GLP-1 agonists in obese patients with HFpEF, a type of heart failure that is associated with significant morbidity and mortality,” said Pooja Prasad, MD, an assistant clinical professor in the Department of Advanced Heart Failure & Transplant Cardiology at the University of California San Francisco.
“While recent randomized clinical trials have rightly generated a lot of interest in GLP-1 agonists, having these results, specifically reduction in the composite outcome of heart failure hospitalizations and all-cause mortality, replicated in a large cohort study will likely increase their utilization even before we see a change in guidelines,” she told Healthline.
Heart failure with preserved ejection fraction (
People with HFpEF are hospitalized an estimated 1.4 times per year and have an annual mortality rate of approximately 15%.
Experts said the new research opens up the possibility of new treatments for people with this form of heart failure.
“As this condition is the most common form of heart failure and is a disease with limited treatment options, these study results offer a tremendous opportunity for us to better manage patients with this diagnosis,” said Cheng-Han Chen, MD, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA.
“These findings are important as they may broaden the indications for these medications and benefit a larger patient population,” added Mir Ali, MD, a general surgeon and bariatric surgeon as well as the medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA.
Ali noted, however, that the study focused on people with high body mass index (BMI) readings. He said he’d like to see research done on the benefits of the weight loss medications on people with this heart condition who don’t have obesity or type 2 diabetes.
“A study separating the weight loss effects (and improvement in diabetes) from other benefits, and elucidating the mechanism, would be helpful to further ascertain how these drugs are working to reduce heart failure,” he told Healthline.
The Centers for Disease Control and Prevention (CDC)
“Obesity affects every organ system in the body — from diabetes, heart disease, arthritis and even cancer. So, it is clear that reducing weight can improve or reverse the deleterious effects of obesity,” said Ali.
“Through a variety of mechanisms, metabolic syndrome increases our risk for cardiovascular disease, which can manifest as both acute and chronic blockages in the arteries supplying blood to our heart, strokes, heart rhythm abnormalities, and heart failure (weakness and stiffness of the heart muscle).”
“The GLP1 [weight loss] drugs are the best available medications for treatment of obesity. If the patient meets the criteria for surgery, that is even more effective,” Ali said.
“We need to stop thinking of HFpEF as purely a cardiac disease,” added Prasad. “It is a consequence of metabolic syndrome, and treating it requires addressing metabolic syndrome, of which obesity is one key component.”
Chen told Healthline there are a number of lifestyle factors people can adopt to improve their cardiovascular health. They include:
- regular physical activity
- eating a healthy balanced diet
- getting an adequate amount of quality sleep
- maintaining a healthy weight
- avoiding tobacco and alcohol
- controlling blood pressure and cholesterol numbers
Experts say a heart-healthy diet should avoid ultra-processed foods, sugars, and unhealthy fats.
- leafy green vegetables
- whole grains
- berries
- beans
- tomatoes
- almonds
Ali added that it’s essential that people adopt healthy habits, even if they are taking weight loss medications.
“Patients need to realize that counseling, medications, and even surgery are tools to help the patient adopt a healthier diet and lifestyle, and like any other tool, if used properly, it works well,” he said. “However, it still requires the proper effort on the part of the patient.”
