
Experts Encourage Use of GLP-1s in Cardiovascular Care
Key Takeaways
- GLP-1 inhibitors significantly reduce cardiovascular events and mortality, with promising results in weight reduction and heart failure symptom improvement.
- Clinicians should incorporate GLP-1s into practice, as they are endorsed by cardiology guidelines and show efficacy in reducing cardiovascular events.
Glucagon-like peptide-1 (GLP-1) inhibitors have proven effective in preventing cardiovascular events, leading to experts promoting their use outside of care for diabetes.
The last day of the
Vinita Aroda, MD, director of diabetes clinical research at Harvard Medical School, opened the session by describing the evolution of GLP-1s over the years, starting in 2005 with Exenatide BID, where patients saw about 2 pounds of weight loss and flattening
“Then came the combination tirzepatide [glucose-dependent insulinotropic polypeptide] and GLP-1 receptor agonist, which again has opened up a new wave of another unfolding, so to speak,” said Aroda. “For the first time, we saw that more than 50% of people achieved an [hemoglobin] A1c less than 5.7.”
Recent studies into the effects of GLP-1s on cardiovascular events have also been promising, with a
She also presented data on how trizepatide and semaglutide led to
When it comes to offering GLP-1s to patients, Aroda said that clinicians should discuss the medication with the patient by emphasizing the goals of decreasing the risk of heart and kidney disease and optimizing long-term health and explaining what the patient should expect after starting the medication. Explaining that the patient should remain hydrated and introduce muscle resistance training is also vital, she said.
“It isn’t about getting to the highest dose fast enough or maximum efficacy. It’s understanding the patient in front of you, educating, escalating to an appropriate dose, acknowledging the potential effects, and modifying to the patient,” Aroda concluded.
Darren McGuire, MD, MHSc, distinguished teaching professor of medicine at University of Texas Southwestern Medical Center, encouraged cardiologists to use GLP-1s in their practice given this data, as most cardiology clinics in the US are only prescribing these medications in the single digits, despite the decade of data.
“We have 3 medications, injectable, that have FDA product label indications. And these have unequivocally entered the guidelines, both the endocrinology guidelines you saw from [Aroda] earlier but also our cardiology guidelines, most recently the European Society for Cardiology guidelines from 2023. So these are now unequivocally endorsed as level 1a cardiovascular medications,” he said.
McGuire shared the results of the
When it comes to cardiovascular use specifically, he pointed out the SUMMIT trial,5 which found that tirzepatide was able to decrease the cumulative incidence of death from cardiovascular causes or a worsening heart-failure event when compared with placebo over the course of 136 weeks, with separation in outcomes starting as early as 24 weeks.
GLP-1s have expanded in use beyond diabetes and obesity, said McGuire, with researchers continuing to expand the use of the drugs to kidney disease, heart failure with preserved ejection fraction, and metabolic associated liver disease. Because many of those indications can affect cardiovascular disease, the use of GLP-1s is vital in cardiology.
“These have to become part of our usual arsenal. We have guidelines and professional society endorsements. These should immediately impact care, not just in the endocrinology clinics and not just in primary care, but in the cardiology clinic,” he concluded.
References
1. Aroda VR. A review of GLP-1 receptor agonists: evolution and advancement, through the lens of randomized controlled trials. Diabetes Obes Metab. 2018;20 Suppl 1:22-33. doi:10.1111/dom.13162
2. Aroda VR, Rosenstock J, Terauchi Y, et al; PIONEER 1 Investigators. PIONEER 1: randomized clinical trial of the efficacy and safety of oral semaglutide monotherapy in comparison with placebo in patients with type 2 diabetes. Diabetes Care. 2019;42(9):1724-1732. doi:10.2337/dc19-0749
3. Rivera FB, Cruz LLA, Magalong JV, et al. Cardiovascular and renal outcomes of glucagon-like peptide 1 receptor agonists among patients with and without type 2 diabetes mellitus: a meta-analysis of randomized placebo-controlled trials. Am J Prev Cardiol. 2024;18:100679. doi:10.1016/j.ajpc.2024.100679
4. Kosiborod MN, Abildstrøm SZ, Borlaug BA, et al; STEP-HFpEF Trial committees and Investigators. N Engl J Med. 2023;389:1069-1084. doi:10.1056/NEJMoa2306963
5. Packer M, Zile MR, Kramer CM, et al; SUMMIT Trial Study Group. Tirzepatide for heart failure with preserved ejection fraction and obesity. N Engl J Med. 2025;392:427-437. doi:10.1056/NEJMoa2410027
6. McGuire DK, Busui RP, Deanfield J, et al. Effects of oral semaglutide on cardiovascular outcomes in individuals with type 2 diabetes and established atherosclerotic cardiovascular disease and/or chronic kidney disease: design and baseline characteristics of SOUL, a randomized trial. Diabetes Obes Metab. 2023;25(7):1932-1941. doi:10.1111/dom.15058
7. Lilly’s Mounjaro (tirzepatide), a GIP/GLP-1 dual agonist, demonstrated cardiovascular protection in landmark head-to-head trial, reinforcing its benefit in patients with type 2 diabetes and heart disease. News release. Lilly. July 31, 2025. Accessed August 3, 2025.
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