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Trial finds weight loss drug can reduce cardiovascular events in overweight adults

The injectable drug Ozempic is shown Saturday, July 1, 2023, in Houston.
David J. Phillip
Associated Press
The injectable drug Ozempic is shown Saturday, July 1, 2023, in Houston.

The prescription weight loss drug semaglutide, known by the brand names Ozempic and Wegovy, can help prevent cardiovascular disease in overweight adults, according to a recent international trial that included the Cleveland Clinic.

One in five of the trial’s participants, who were overweight adults with no history of diabetes, saw improvements in several risk factors for cardiovascular disease after taking the drug, which is commonly used to treat diabetes, said Clinic cardiologist Dr. Michael Lincoff, who will present the findings Saturday at the American Heart Association’s scientific sessions.

Lincoff said the concept of treating obesity to reduce cardiovascular complications has been hampered by the lack of evidence that lifestyle or pharmacologic interventions for overweight or obesity improve cardiovascular outcomes.

"This marks the first intervention, either a lifestyle or pharmacologic intervention, that's ever been shown to reduce the risk of cardiovascular events in patients who have overweight and obesity but don't have diabetes," Lincoff noted.

The trial's results were published in the New England Journal of Medicine.

Semaglutide, which is typically used by adults with type II diabetes to control blood sugar, can also be prescribed for weight management in adults with obesity and at least one other health condition.

Trial patients treated with semaglutide lost an average of 9.4% of their body weight and saw improvements in a number of other risk factors for cardiovascular disease, according to the Cleveland Clinic.

The trial ran from October 2018 through June 2023. Patients were age 45 and older with preexisting cardiovascular disease and a body-mass index of 27 or greater. More than 17,000 patients in 41 countries who previously had a heart attack, stroke and or peripheral artery disease received a weekly dose of semaglutide or placebo and were followed for an average of 40 months.

In the trial, for overweight patients with preexisting cardiovascular disease but without diabetes, weekly injections of semaglutide at a dose of 2.4 mg was superior to placebo in reducing the risk of death from cardiovascular causes, nonfatal heart attack or nonfatal stroke over an average follow-up of 40 months.

While the weight loss effects of semaglutide appear to occur primarily through appetite suppression, Cleveland Clinic said the drug's additional impacts on reducing cardiovascular risk include improvements in glucose levels, decreases in blood pressure and cholesterol levels and reductions in inflammation.

According to the Cleveland Clinic, more than half of the world population is projected to be overweight or obese by 2035. High body-mass index is estimated to have accounted for 4 million deaths globally in 2015, more than two-thirds of which were caused by cardiovascular diseases, the Clinic noted in a news release.

"The key takeaway is that those who have cardiovascular disease and have overweight and obesity, this may be an important new therapy to be added to their regimen," Lincoff said.

Stephanie Metzger-Lawrence is a digital producer for the engaged journalism team at Ideastream Public Media.