Potential Heart Benefits of Semaglutide for Heart Failure Patients

A recent analysis indicates that taking oral semaglutide might lower hospitalizations and deaths related to heart issues for individuals with a history of heart failure and type 2 diabetes.

The research reexamines data from a trial sponsored by Novo Nordisk, the company behind semaglutide, which is used under different brand names for weight loss and diabetes management. An international team of researchers participated in this analysis.

This double-blind study included nearly 9,650 participants from 33 countries, recruited between 2019 and 2021, and followed for around four years on average.

Results showed that, by the end of the study, participants with a history of heart failure experienced 22 percent fewer negative cardiovascular events while taking semaglutide daily compared to those receiving a placebo. However, no heart health advantages were observed in individuals without prior heart conditions.

According to Rodica Pop-Busui and colleagues from Oregon Health & Science University, “These data support the potential benefit of oral semaglutide in reducing heart failure events in people with type 2 diabetes and heart conditions.”

They also noted some limitations, such as the smaller number of participants in certain subgroups in this secondary analysis.

These findings align with previous studies suggesting that semaglutide could decrease cardiovascular events, such as strokes and heart attacks, by nearly 20 percent over about three years. Notably, these benefits seem to occur independently of weight loss.

However, animal research warns that these potential cardiovascular benefits could come with serious risks, alongside typical side effects like nausea and vomiting.

A study in 2024 showed that semaglutide might cause a reduction in a specific muscle type in mammalian hearts, while other studies have reported significant loss of skeletal muscle alongside its weight loss and anti-diabetic effects.

As with any medication, careful monitoring of semaglutide’s side effects is essential, particularly as the longer-term consequences are still being explored.

Globally, type 2 diabetes affects about half a billion people, with heart failure being a common complication. For those at risk, the benefits of semaglutide may outweigh its risks when managed appropriately. However, other options, such as bariatric surgery, remain more effective for blood sugar management than this drug.

And, since the underlying mechanisms of semaglutide’s effects on cardiovascular health are not yet fully understood, experts suggest caution in broadly prescribing this medication for purposes beyond diabetes and weight management.

This research appears in JAMA.