Semaglutide Update: New Evidence Indicates Prevention of Heart Attack and Stroke

Explore the prevalence of heart disease, and how semaglutide can effectively reduce the risk of cardiovascular events like heart attack and stroke.

Dr. Thomas Macsay, ND
Medically reviewed by
Dr. Thomas Macsay, ND
Written by
Dr. Thomas Macsay, ND
Published on
April 1, 2024

Heart disease remains a significant public health concern in the United States, with approximately 29% Americans dying from heart-related complications each year, according to the Centers for Disease Control and Prevention (CDC).

This makes heart disease the leading cause of death for adults living in the United States.

Individuals with obesity and type 2 diabetes are particularly at risk for heart attack and stroke, in addition to a plethora of other health complications that can lead to preventable causes of death. As of 2024, roughly 70% (2 out of 3) of U.S. adults are overweight or obese, highlighting the importance of effective prevention strategies.

Semaglutide, a GLP-1 receptor agonist initially developed for diabetes management, now has FDA approval to not only promote effective weight loss but also in the prevention of cardiovascular events such as heart attack and stroke.

Prevalence of Heart Disease and Impact on Morbidity

Heart disease, including conditions such as coronary artery disease, heart failure, and arrhythmias, and clotting events is the leading cause of death in the United States.   

It affects individuals of all ages and backgrounds, leading to significant morbidity and healthcare costs. According to the American Heart Association, approximately 121.5 million Americans have some form of cardiovascular disease, and the economic burden of heart disease and stroke is estimated to be over $200 billion annually.  

Individuals with obesity and diabetes are at an increased risk of developing heart disease due to factors such as insulin resistance, inflammation, and dyslipidemia. Despite education and nutrition program efforts that have been put in place over the last couple of decades, the evidence shows that Americans are becoming overweight earlier in life leading to increased chance of health complications over time.   

 The presence of these comorbidities further exacerbates the risk of heart attack and stroke, underscoring the need for effective preventive strategies to reduce the burden of cardiovascular disease in the population.  

How Does Semaglutide Prevent Heart Attack and Stroke:  

Semaglutide exerts its effects through multiple mechanisms that contribute to its cardiovascular benefits. One of the key pathways by which semaglutide prevents heart attack and stroke is by reducing inflammation and improving endothelial (vascular) function.   

Studies have shown that semaglutide decreases inflammatory markers such as C-reactive protein, which are associated with a higher risk of cardiovascular events, as inflammation leads to increased blood clotting and risk of vascular injury.   

Additionally, semaglutide enhances endothelial function by increasing nitric oxide production and reducing oxidative stress, leading to improved vascular health and reduced risk of atherosclerosis. These effects are crucial in preventing the formation of arterial plaques that can occlude blood vessels and cause heart attack and stroke.  

The mechanisms are all in addition to semaglutide’s ability to lower lipid levels and decrease blood sugar levels which both increase the risk of vascular injury and plaque buildup throughout the cardiovascular system.   

Clinical Evidence Supporting the Cardiovascular Benefits of Semaglutide:  

Multiple randomized controlled trials have demonstrated the cardiovascular benefits of semaglutide in patients with type 2 diabetes. The SUSTAIN-6 trial, published in the New England Journal of Medicine in 2016, reported a 26% reduction in cardiovascular events, including heart attack and stroke, in individuals treated with semaglutide compared to placebo.  

Furthermore, a study published in Cardiovascular Diabetology in 2018 found that semaglutide reduced the risk of major adverse cardiovascular events by 39% in patients with type 2 diabetes and established cardiovascular disease. These findings highlight the potential of semaglutide in preventing heart disease and stroke in high-risk individuals.  

A study released in 2023 in the Journal of the American Heart Association, indicates that weight loss caused by semaglutide has been associated with moderate improvements in cardiometabolic measures, such as blood pressure, glucose control, high-density lipoprotein cholesterol, and triglycerides, in adults with overweight or obesity. Evidence for the benefits of clinically meaningful weight loss (defined as ≥5% of initial body weight) on cardiovascular disease has been well documented.    

The most recent clinical study by Novo Nordisk, with over 17,000 subjects, indicated that semaglutide could prevent cardiovascular events by up to 20% in overweight and obese individuals. These findings have allowed the FDA to approve semaglutide for the prevention of heart attack and strokes in patients with cardiovascular disease, further exposing the clinical effectiveness and versatility of semaglutide.  


Semaglutide's ability to prevent heart attack and stroke represents a significant advancement in the management of obesity and diabetes, two major risk factors for cardiovascular disease.   

By targeting inflammation, improving endothelial function, and reducing cardiovascular risk, semaglutide offers a promising option for individuals at risk of heart-related complications.   

With proven safety and efficacy, semaglutide offers the most effective therapeutic potential to prevent cardiovascular disease related to metabolic dysfunction. GLP-1's have long been considered one of the best long-term medications to control blood sugar, now the next generation is proving to be even more effective as the scientific evidence in support of its use continues to mount.   


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