Beyond Blood Sugar: A Cardiovascular Win

On 07 December 2024, Novo Nordisk released new data from its SELECT trial, showing that semaglutide, a GLP-1 receptor agonist originally developed for type 2 diabetes and obesity, also delivers substantial cardiovascular benefits. The trial demonstrated a 21% reduction in heart failure hospitalizations among patients with obesity and prior cardiovascular disease, independent of diabetes status.

This marks a major expansion of semaglutide’s therapeutic profile, reinforcing the growing recognition of GLP-1 agonists as multisystem agents that address metabolic, cardiovascular, and inflammatory pathways.

Trial Design and Key Findings

The SELECT trial enrolled over 17,000 participants across 41 countries, all with established cardiovascular disease but without diabetes. Participants received weekly semaglutide injections over a median follow-up of 3.5 years.

Key outcomes included:

• A 20% reduction in major adverse cardiovascular events (MACE)
• A 21% drop in heart failure-related hospitalizations
• Improvements in weight, blood pressure, and inflammatory markers

Importantly, the benefits were consistent across age groups, sexes, and baseline BMI categories.

Implications for Clinical Practice

These findings could reshape treatment guidelines for patients with obesity and cardiovascular risk, even in the absence of diabetes. Cardiologists and endocrinologists are now considering GLP-1 agonists as part of standard preventive care, especially for patients with heart failure with preserved ejection fraction (HFpEF), a notoriously difficult-to-treat condition.

Novo Nordisk plans to file for expanded indications in early 2025, and payers are already evaluating coverage models to reflect the drug’s broader utility.