Living in Los Angeles, it is likely that you have come across Ozempic and Wegovy in one place or another. People talk about it, and it is advertised online, in and out of clinic offices. They are primarily seen as weight loss medications. However, if you are a cardiac patient, or one that could be at risk of a developing heart condition, there is a much larger picture

For a cardiac patient, these medications are recently seen as one of the most important advances in medicine. As a cardiac surgeon at Ronald Reagan UCLA, I want my patients to have the best and right information there is to have about the benefits of these medications and the questions that need to be directed to the medical team.

WHAT ARE GLP-1 MEDICATIONS

GLP-1 is a medical term for Glucagon like peptide-1 which is produced in the intestines. It helps manage blood sugar after eating and it also tells the brain that it is full. GLP-1 receptor agonists are medications that act like this specific hormone.

Some of the well-known GLP-1 drugs are:

– Semaglutide – which is sold as Ozempic (for the treatment of diabetes) and as Wegovy (for the treatment of weight management)
– Tirzepatide – sold as Mounjaro and Zepbound
– Dulaglutide – sold as Trulicity

These substances were first created for the treatment of Type 2 diabetes; however, further research revealed that these medications also positively affect other areas of health, such as increasing positive outcomes related to cardiovascular health.

Impact on Heart Health

This is a particularly significant development for patients with cardiac conditions.

In 2024, the FDA approved the use of semaglutide for people with cardiovascular disease and obesity or overweight to help prevent heart attacks and strokes. This was a landmark occasion as it was the first approval of a a weight loss medication to target cardiovascular disease.

The SELECT trial is what drove that decision. This large study included over 17,500 patients. It was shown that the addition of semaglutide to standard care led to significant occurrences of heart attack, stroke, or death from cardiovascular disease. MedStar Health

Researchers were surprised by the rapidity of that benefit. In the SELECT trial, patients with a history of heart attack or stroke experienced a recurrence of a cardiac event prior to significant weight loss while using Wegovy, the risk was reduced in just three months. The University of Kansas Health System

This finding is impressive, signaling that the cardiac advantages of GLP-1 medications are inaccessible via psychosomatic means, rather through concrete biological mechanisms.

Beyond Weight Loss: Direct Cardiac Effects

For a long time, the main advantage of GLP-1 medications for the heart was attributed to the weight loss that they induce. New research is beginning to contradict that belief.

A new study in The Lancet from University College London examined how 17604 adult patients recorded as overweight with existing cardiovascular illness. It was discovered that regardless of how much weight a person lost during treatment, semaglutide was effective in preventing heart attacks and other serious cardiovascular events. ScienceDaily.

Studies from the Technical University of Munich and Harvard Medical School identified that both semaglutide and tirzepatide have the potential to decrease the chances of serious cardiac events by 18%. This research reflects that the positive impact from these drugs is seen even if patients have not achieved significant weight loss. ScienceDaily.

These drugs have also demonstrated a positive impact on reducing cholesterol plaques that promote atherosclerosis, and show improved function of a number of kidney parameters that affect heart health. MedStar Health.

The most recent study from the University of Bristol and University College London discovered that GLP-1 medications may help improve heart function post myocardial infarction by opening small collateral blood vessels that are often found to be closed even after a cardiac catheterization on the main artery. This may be a significant advancement in reducing the impact of heart attacks, as up to 50% of patients develop serious complications during a heart attack. ScienceDaily

What About Side Effects?

No medications are free from harm, and GLP-1 medications also have associated risks.

Before taking any of these drugs, it is best to discuss the risks and benefits with your physician.

Side effects such as nausea, cramps, diarrhea, and other gastric issues are common with the initiation of these drugs. These effects can make it difficult to continue taking the medications, although they often subside with continued usage. MedStar Health.

The only potentially cardiac relevant effect is a small increase in resting heart rate. With no other serious heart problems presented with this drug class after almost 20 years, MedStar Health considered the.

Other factors, such as the risk of muscle tissue loss during quick adjustments in weight and problems with other prescriptions you are taking for heart disease, should also be evaluated with your team.

Who should take GLP-1?

Not every patient is a candidate for GLP-1 medications, nor should they be considered instead of the other fundamental factors of cardiovascular disease prevention. These include a heart-healthy lifestyle, regular exercise, smoking cessation, and the use of prescribed drugs.

Reduced risk of cardiovascular disease can be achieved by positive lifestyle changes such as diet, exercise, and changing sleep patterns. These provide the greatest benefit when used in conjunction with the GLP-1 medications, as they provide little cardiovascular benefit by themselves, U.S. News & World Report.

A study at Harvard school of Medicine has found that incorporating lifestyle changes with GLP-1 receptor agonists (medications that activate GLP-1 receptors), leads to improvement of the patient’s health in the cardiovascular department. (Cardiovascular Business)

With that being said in looking at which patients would benefit the most from this medication, an important conversation with the patient’s cardiologist would include patients that have:

– Type 2 Diabetes and have cardiovascular disease
– The patient is in the overweight/obesity category (BMI of 27+) and has had a heart attack or stroke
– The patient has had a hard time losing weight with lifestyle changes and needs a pharmacological aid
– The patient has multiple cardiovascular diseases and has poor control of blood pressure and diabetes (metabolic syndrome)

A note about Access and Los Angeles:

An important factor for patients living in Los Angeles and the surrounding areas is the cost. GLP-1 medications are expensive. Coverage is very inconsistent and insurance companies are slow to cover the new medications. One notable exception is that, as of this year, all Medicare Part D plans are covering Wegovy if it prescribed for a patient’s cardiovascular reason. This is a win for older patients with heart disease. If you are having trouble with insurance, it is often possible to get your cardiologist office to do the insurance auth paperwork.

The market of GLP-1 medications is changing rapidly. In LA, there is an increase of compounded versions of medications and telehealth prescribed medications, which are of varying quality and safety. Always get GLP-1 medications from a licensed provider and pharmacy.

The Bottom Line

Ozempic and Wegovy are GLP-1 medications that have a positive impact on cardiovascular medicine and are not only a weight loss fad. The evidence of their benefits is substantial and heart protective impacts are growing. For certain patients, GLP-1 medications are an important part of a comprehensive cardiac care plan.

If you have heart disease, have had a heart attack, stroke, or have cardiovascular risk factors, definitely speak to your care team about this.

As cardiac surgeon for patients in Los Angeles and Westwood, I have a special interest in helping patients with these evolving treatment options.