[Nov. 15, 2023: JJ Shavit, The Brighter Side of News]
Marks the first time that a weight-loss medication has demonstrated its ability to protect obese adults against severe heart-related issues. (CREDIT: Creative Commons)
In a groundbreaking development, a recent study has revealed that the weight-loss drug Wegovy has the potential to reduce the risk of heart attacks and strokes by a significant 20% in adults suffering from both heart disease and obesity.
This revolutionary finding marks the first time that a weight-loss medication has demonstrated its ability to protect obese adults against severe heart-related complications, potentially opening up a promising avenue for treating heart disease, which remains the leading cause of death in the United States.
Presented at the 2023 American Heart Association Scientific Sessions in Philadelphia and concurrently published in the New England Journal of Medicine, these findings have far-reaching implications. They could potentially reshape insurance coverage policies regarding weight-loss medications, an area that has faced reluctance in the past. Currently, insurance providers have been hesitant to offer coverage for such drugs, and Medicare, as mandated by law, is prohibited from extending coverage to them.
Dr. Eric Topol, a distinguished cardiologist and Executive Vice President of Scripps Research in California, shared his perspective on this development: "I think this will force insurance and Medicare to consider reimbursement."
The implications are enormous for individuals grappling with heart disease, as weight-related issues play a significant role in cardiovascular health. Nearly 70% of the U.S. population is either overweight or obese.
Dr. Michael Lincoff, the lead author of the study and a cardiologist at the Cleveland Clinic, emphasized the significance of this discovery: "This is a pretty big deal. Just being overweight or having obesity is a risk factor for increased risk of heart disease, and yet we’ve had no treatment that addressed that specific risk factor."
The study involved more than 17,600 participants, all aged 45 and above, suffering from heart disease without diabetes. They were randomly assigned to receive either a weekly 2.4-milligram dose of semaglutide, the active ingredient in Wegovy, or a placebo. Notably, individuals who had experienced a heart attack or stroke within the last 60 days were not eligible for participation.
A recent study has revealed that the weight-loss drug Wegovy has the potential to reduce the risk of heart attacks. (CREDIT: Creative Commons)
Over a follow-up period of approximately three years, the researchers observed a substantial reduction in cardiovascular events, including heart attacks, strokes, or death related to heart disease, in the Wegovy group compared to the placebo group. Specifically, there were 569 cardiovascular events in the Wegovy group as opposed to 701 in the placebo group, translating to a remarkable 20% lower risk in individuals who had taken Wegovy.
Dr. Amit Khera, the Director of the Preventive Cardiology Program at UT Southwestern Medical Center in Texas, co-authored an editorial published alongside the study and remarked on the significance of this development: "That is significant. We finally have some treatments that are not only very effective for weight loss, but also seem to be very beneficial for heart disease."
The trial included more than 17,600 adults ages 45 and up with heart disease who got either a weekly 2.4-milligram dose of semaglutide, (CREDIT: Creative Commons)
This discovery is particularly groundbreaking because previous weight-loss medications, such as phentermine or orlistat, failed to demonstrate their ability to shield patients from severe heart-related issues. In fact, the weight-loss drug fen-phen was withdrawn from the U.S. market in the late 1990s due to its association with serious heart problems.
Dr. Susan Spratt, an endocrinologist and the Senior Medical Director for the Population Health Management Office at Duke Health in North Carolina, hailed this breakthrough: "This is amazing evidence that semaglutide not only helps people with diabetes prevent devastating complications but also helps patients with obesity lose weight and avoid major adverse heart consequences." (Semaglutide is also approved as a diabetes drug under the name Ozempic.)
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes. (CREDIT: New England Journal of Medecine)
Despite these exciting findings, researchers are still striving to understand the precise mechanism by which Wegovy prevents serious heart problems in overweight patients. Dr. Nishant Shah, a preventive cardiologist at Duke University Medical Center, acknowledged this knowledge gap, stating that further investigation is needed to unravel the mystery: "That question is under investigation right now."
Dr. Lincoff, the study's author, speculated that inflammation might play a pivotal role in this process. Inflammation can trigger the rupture of plaques in arteries, leading to blood clots, heart attacks, and strokes. Notably, patients taking Wegovy in the trial experienced reductions in inflammation similar to those seen in patients using statins.
Characteristics of the patients at baseline. (CREDIT: New England Journal of Medecine)
Additional research presented at the American Heart Association conference provided further support for the theory that weight loss drugs might reduce inflammation in patients with heart disease. Researchers at Mount Sinai Health System in New York City examined how tirzepatide, a weight loss drug similar to semaglutide, impacted inflammation in patients with Type 2 diabetes and heart disease. The study revealed significant reductions in C-reactive protein (CRP), a marker of inflammation, in the tirzepatide group.
Dr. Deepak Bhatt, a cardiologist at Mount Sinai and the study's author, noted the substantial reduction in inflammation: "That's an enormous reduction in inflammation." However, he cautioned that further randomized clinical trials are necessary to confirm the cardiovascular benefits of these drugs.
Dr. Topol, from Scripps Research, emphasized the potential of these newer weight loss drugs to become groundbreaking treatments for heart disease. Nonetheless, he pointed out that additional research is required to determine how well Wegovy lowers cardiovascular risk in obese patients without pre-existing heart disease: "We need a lot more work to find out if people who aren't so high-risk would benefit."
Dr. Lincoff echoed this sentiment, highlighting that further analyses, including subgroup assessments, will be conducted in the coming year to gain a deeper understanding of how Wegovy prevents heart problems and which individuals stand to benefit the most.
While the potential of Wegovy and similar drugs to address the obesity-related aspect of heart disease is promising, it is essential to consider broader public health issues. Obesity remains a major public health concern, and addressing equity concerns related to access to these expensive medications is crucial.
Dr. Khera underlined this point: "We also have to appreciate that these drugs are really expensive, and a lot of people will not be able to access them. So as much as we're looking at the drug, we still need to look upstream as to why we have obesity and downstream about people who can't afford them."
The groundbreaking findings on Wegovy's potential to reduce heart attack and stroke risk in adults with heart disease and obesity represent a significant step forward in cardiovascular medicine. This development has the potential to reshape how we approach the treatment and prevention of heart disease, a leading cause of death in the United States.
However, further research is needed to uncover the underlying mechanisms and assess its applicability to a broader population. Additionally, addressing issues of accessibility and equity in obesity treatment remains a critical aspect of public health efforts.
For more science and technology stories check out our New Discoveries section at The Brighter Side of News.
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