GLP-1 Drugs May Prevent 34,00 Heart Attacks, Strokes a Year

• GLP-1s, the class of drugs including Ozempic and Mounjaro, treat diabetes and obesity, but some have also shown significant cardiovascular benefits.
• Millions of Americans might benefit from taking GLP-1 drugs for cardiovascular disease.
• New research suggests GLP-1 drugs could prevent up to 34,000 strokes and heart attacks annually.

GLP-1 drugs like Ozempic, Mounjaro, Wegovy, and Zepbound are powerful tools for treating diabetes and aiding with weight loss, but a new study suggests these medications could also help prevent cardiovascular disease, heart attack, and stroke in millions of people, suggests new research.

Previous clinical trials have shown that some Glucagon-like peptide-1 receptor agonists (GLP-1s) can help prevent cardiovascular disease. However, those benefits have only been demonstrated for secondary prevention in high risk individuals: those who’ve previously experienced a heart attack or stroke or have established cardiovascular disease.

However, new research from Dandelion Health, a company specializing in “real-world data and clinical AI,” indicates that GLP-1 drugs could have broad implications for the heart health of millions of Americans, potentially preventing more than 30,000 heart attacks and strokes each year in the United States.

Since prior trials have been limited to high risk individuals, Dandelion wanted to investigate what the potential health benefits could be among people with only mild or moderate CVD who had never had a prior heart attack or stroke — a population comprising tens of millions of Americans.

That’s an important demographic, but it is difficult (and expensive) to study in a clinical trial setting.

By using AI-driven algorithms to sift through real-world data — everything from electrocardiogram readings to physician notes — Dandelion claims it is able to “assess treatment efficacy faster and at a greater scale than ever before.”

“What we showed was that patients who initiate treatment with GLP-1s have a lower cardiovascular risk after three years than similar patients who are not taking GLP-1s,” Nick Gossen, Head of Growth at Dandelion Health, told Healthline.

“Our study is consistent with some of the clinical trials that have gone through the FDA and gotten approval,” he added.

Dandelion’s research emphasized several findings:

• GLP-1s could potentially serve as primary prevention for heart attack and stroke for patients with obesity and mild or moderate CVD — about 44 million additional patients in the US.
• Patients taking GLP-1s had a 15-20% reduction in MACE (heart attack and stroke), which is consistent with clinical trials conducted by Novo Nordisk, the maker of Ozempic and Wegovy.
• Using predictive AI, the company found that patients taking GLP-1s would see a cardiovascular benefit in under two years.

Those findings are promising but should be taken with a grain of salt. The study itself has not yet been peer-reviewed, though Gossen said that they are currently pursuing that.

“This is intended to be a proof of concept: It’s pretty clear that there’s a signal there. With additional work and peer review and going through the FDA process, we think this is a very practical demonstration of how AI can be used both to shape clinical trials and make them more inclusive and lower cost,” he said.

This marked the first time that any weight loss medication was also approved to prevent cardiovascular disease, heart attack, and stroke. Ozempic, which shares the same active ingredient as Wegovy, but is indicated to treat type 2 diabetes, received FDA approval for a cardiovascular disease indication four years earlier, in 2020.

Clinical trials from Novo Nordisk, the manufacturer of Ozempic and Wegovy, have consistently shown the benefits of these drugs in preventing cardiovascular disease in patients with obesity and type 2 diabetes. The results of the Sustain-6 trial, published in 2016, showed that in patients with type 2 diabetes, Ozempic reduced the risk of death from cardiovascular disease, heart attack, and stroke by 26 percent.

The more recent Select trial cleared the way for the FDA’s approval of Wegovy’s CVD indication by demonstrating a 20% reduced risk of MACE in patients with obesity.

Chad S. Weldy, MD, PhD, a Cardiologist at Stanford Medicine, told Healthline that GLP-1s are clearly promising for CVD prevention.

“The past 10 years have now fully established the remarkable benefit of GLP-1 therapies in those overweight and obese individuals with diabetes as well as those without diabetes and established cardiovascular disease,” said Weldy.

However, making the leap from using GLP-1 for secondary prevention to primary prevention is a large one due to the difficulty and expense of a clinical trial — a fact both he and Gossen acknowledge.

“It is highly likely that GLP-1 drugs will provide benefits for primary prevention to prevent cardiovascular disease as measured by MACE outcomes. The challenge is how this potential primary prevention clinical trial is designed,” Weldy told Healthline.

Since heart attacks and other major cardiovascular events are relatively uncommon in this generally healthy population, such a study would require potentially tens of thousands of participants and many years of follow-up. All of those parameters would also make it tremendously expensive to conduct.

Not impossible, but difficult and unfeasible.

While Dandelion’s research may be a proof of concept, Weldy cautions that it is still a long way from being a substitute for randomized, controlled clinical trials, which are the “gold standard” for medical research and essential to the FDA approval process.

Additionally, he notes that the suggestion of expanding GLP-1 prescriptions to tens of millions of Americans — therapies that are expensive and potentially lifelong — represents its own unique challenges to the U.S. healthcare system.

“If a large trial is performed for GLP-1 therapy, enrolling anyone who is overweight or obese without known CVD, and…we see a significant reduction in CV events from a primary prevention perspective, a big question would be, “Who do you not treat with this therapy?” Weldy asked.

GLP-1 drugs have the potential to reduce the number of heart attacks and strokes in the United States by as much as 34,000 annually, according to Dandelion Health.

To reach that goal, GLP-1s would need to be prescribed to tens of millions of Americans with mild or moderate CVD.

Experts told Healthline that GLP-1s are a promising line of drugs in the fight against cardiovascular disease but that more research will be needed before they could be indicated for primary prevention of CVD.