A new analysis of data from the SELECT trial shows that semaglutide, a GLP-1 receptor agonist, provides a clear cardiovascular protective effect in people with overweight or obesity and already established cardiovascular disease, even when they do not have diabetes.
What did the SELECT study show?
- The study included over 17,600 participants who received either semaglutide or placebo and were followed for an average of about 3.3 years.
- In the semaglutide group, fewer serious cardiovascular events, such as death due to heart disease, heart attack or stroke, occurred compared with placebo (hazard ratio 0.80).
- The relative risk of major events (MACE – “major adverse cardiovascular events”) fell by around 20%.
What is especially interesting: the effect seems to go beyond weight loss
- A revised interpretation of the results suggests that the protective effects are partly independent of weight loss, it was therefore not only the participants’ weight loss that protected their hearts.
- The mechanisms are thought to include improved metabolism, reduced inflammation and direct effects on blood-vessel function – not only fat reduction.
- The protective effect was seen across several BMI levels, including in people with moderate overweight, not just class I/II obesity.
What does this mean for patients & our practice
- GLP-1 treatment with semaglutide can offer cardiovascular protection beyond pure weight loss, a potentially valuable tool in treating overweight, together with established cardiovascular disease.
- The effect is documented even in non-diabetics with overweight/obesity, a broader patient group than previously assumed.
- Important: the results are promising, but this is still a medical treatment. As always, a holistic view is needed: risk factors, lifestyle, follow-up and individual assessment.
🔎 Conclusion
The SELECT study strengthens the view of GLP-1 medications as more than weight-loss aids; they can be part of modern strategies to reduce cardiovascular disease in people with overweight or obesity. The results open the door to viewing treatments like semaglutide not only as weight-focused, but as part of cardiovascular preventive care
Can GLP-1 medications improve survival in colorectal cancer?
A new study from the University of California investigated the association between GLP-1 receptor agonists (GLP-1 medications) and five-year mortality in patients with primary colorectal cancer. The study included 6,871 patients and showed that users of GLP-1 medications had a five-year mortality of 15.5%, compared with 37.1% among those who did not use GLP-1. This corresponds to a markedly lower risk of death (OR 0.38; 95% CI 0.21–0.64).
The effect remained even after adjustment for disease stage and other factors, but when stratified by BMI, it became clear that the pronounced protective effect was mainly seen in patients with severe obesity (BMI > 35).
The researchers suggest that GLP-1 medications may provide a double benefit:
• potentially slowed cancer growth
• reduced risk of heart attack and stroke, which also improves survival
The results were published in Cancer Investigation and are in line with other research on GLP-1 and cancer. At the same time, the study was relatively small, and more, larger studies are needed to determine with certainty how GLP-1 affects survival in colorectal cancer.
