A new analysis from the SELECT trial shows that semaglutide quickly lowers the risk of serious heart problems. This benefit appears even before patients lose much weight or reach the full medication dose. The trial included people with overweight or obesity who already had heart disease, but not diabetes.
Researchers found that patients treated with semaglutide had about 40% fewer major cardiovascular events—like heart attacks—at both 3 and 6 months compared to those on placebo. This was often before most patients reached the target dose of 2.4 mg weekly.
Dr. Jorge Plutzky, lead author and director at Brigham and Women’s Hospital, said these results show semaglutide’s early effect on reducing major heart events. He noted the benefits appear within the first six months and sometimes even earlier.
Semaglutide is a GLP-1 receptor agonist, a type of drug first approved for type 2 diabetes. It also helps with weight loss in people with obesity or overweight who have other health risks. GLP-1 drugs work by mimicking natural hormones that lower blood sugar and reduce hunger, leading to lower calorie intake and weight loss.
The original SELECT trial, published in 2023, showed that semaglutide reduced major cardiac events by 20% over three years in overweight or obese adults with heart disease but no diabetes. Patients were given the drug or placebo without specific diet or weight loss advice.
This new analysis focused on early cardiovascular events within the first year, especially at 3 and 6 months. It included data from over 17,600 adults aged 45 and older from 41 countries. Participants received weekly injections of semaglutide or placebo, gradually increasing to 2.4 mg by week 16.
Results showed a 38% lower risk of major cardiovascular events in the first 3 months and a 41% lower risk at 6 months with semaglutide compared to placebo. Importantly, these effects happened even though most patients had not lost much weight and many had not yet reached the full dose.
Dr. Plutzky said the early benefits might come from semaglutide’s effects on inflammation, blood sugar, blood pressure, or direct impacts on the heart and blood vessels. Early changes in diet or other factors may also play a role. More research is needed to understand exactly how these benefits occur.
It is important to note that SELECT included only patients with existing heart disease, so the findings do not apply to people without previous cardiovascular events. These patients were also on other heart-protective medicines, such as those for cholesterol and blood pressure. Semaglutide provided additional benefits beyond these treatments.
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