International heart experts believe the weight-loss drug Ozempic could be given to millions of healthy adults, amid mounting evidence it also helps protect the body from cardiovascular disease.
While the powerful drug, and similar medicines such as Mounjaro and Wegovy, are incredibly effective at suppressing appetite, world-leading cardiologists have unveiled more than a dozen exciting discoveries about the jabs that go far beyond weight loss.
The findings, revealed at the American Heart Association’s annual conference in Chicago, provide hope to sufferers of deadly heart conditions that, until recently, seemed near-impossible to treat.
Surprisingly, many experts admit they are still unsure why these medicines, known collectively as glucagon-like peptide-1 receptor agonists, or GLP-1 medicines, are so effective at protecting the heart.
Until recently, it was thought that the weight-loss triggered by the weekly injections was the sole reason patients were less likely to suffer cardiovascular complications, as obesity is a leading cause of most forms of chronic disease.
The same logic was used to explain why growing research suggests GLP-1 drugs lower the risk of developing a host of serious conditions, including kidney disease, cancer and even Alzheimer’s. However, multiple studies presented at the conference put paid to this theory.
Patients taking GLP-1 injections – regardless of whether they even lose weight – are significantly less likely to suffer all manner of dangerous heart problems.
One idea floated is that the jabs have an anti-inflammatory property – essentially they are tackling toxic proteins that build up in the blood and raise the risk of heart complications.
Dr Rasha Al-Lamee, one of the UK’s leading cardiologists, said that giving patients GLP-1 drugs before they are obese could protect against cardiovascular risks
Whatever the cause, senior doctors at the conference believe that, in the not-too-distant future, GLP-1 drugs will be as widely taken as cholesterol-busting statins – the cheap, daily tablets taken by more than eight million Britons to significantly cut their risk of heart attacks and strokes.
While many patients on statins are not in immediate danger of heart disease, if left untreated, in a decade or two they would be. Many experts believe GLP-1 drugs will play a similar role.
Dr Rasha Al-Lamee, from Imperial College Healthcare NHS Trust and one of the UK’s leading cardiologists, said: ‘Giving patients these drugs when they’re a healthy weight, or before they are obese, makes perfect sense.
‘I’m not overweight, but if you told me I had elevated cardiovascular risk I would like to take a low-dose GLP-1 for the metabolic protective effect. I have spoken to a number of cardiologists who feel the same, and some are already on the medication.’
Dr Salim Hayek, a heart specialist at the University of Texas, added: ‘We need to start thinking about them as medicines that can prevent illness.’
Experts say that while their belief in the protective power of the jabs may sound bullish, the studies speak for themselves.
Last week The Mail on Sunday was first to report pivotal trial results that showed Mounjaro cut the risk of death and worsening illness in patients with heart failure. The condition, which affects one million Britons, causes extreme breathlessness and life-ruining fatigue. Just half of patients live more than five years after their diagnosis and, until recently, there has been little doctors could offer to help.
In another study, doctors at the Mayo Clinic in Minnesota analysed the medical records of more than 7,000 stroke patients.
They found those on GLP-1s were an astonishing 74 per more likely to be alive and 84 per cent less likely to have suffered a heart attack after two years than those who were not on the drugs.
Roughly 100,000 strokes occur every year in the UK – about one every five minutes. And a third study found that overweight patients on GLP-1s are 29 per cent less likely to suffer a heart attack and 33 per cent less likely to suffer a stroke – putting the protection offered on a par with statins.
Safety, of course, remains a focus, as research suggests that, in rare cases, GLP-1 drugs can trigger pancreatitis, a potentially fatal swelling of the pancreas gland.
Roughly one in every 1,000 patients on Ozempic or Wegovy, which both contain the same active ingredient, semaglutide, will develop the condition. In trials of Mounjaro – which contains the more powerful active ingredient tirzepatide, earning it a reputation as the ‘King Kong’ of weight-loss drugs – around 23 out of every 1,000 patients developed pancreatitis.
Many heart experts believe the weight-loss drug Ozempic could have help protect adults who are currently healthy
In September, Scottish nurse Susan McGowan, 58, died from multiple organ failure, septic shock and pancreatitis after taking just two doses of Mounjaro.
Experts say it will be important to monitor patients for these rare side effects, but argue that all medicines have complications.
‘The more people we have on these drugs, the more we will see rare side effects,’ says Dr Hayek. ‘So we need to find ways of identifying who will benefit the most.’
Crucially, experts believe the benefits of the revolutionary injections far outweigh the risks.
‘We used to think these were weight-loss medicines, but that’s not the case,’ says Professor Alex Miras, consultant endocrinologist at Ulster University. ‘These are cardiovascular drugs that just happen to cause weight-loss, and a lot of people may stand to benefit.’
Of course, it wasn’t ALL about Ozempic at the world-renowned conference. Read on to find out more exciting developments…
Two-in-one pills that lower blood pressure
Heart experts called on UK health chiefs to offer patients with high blood pressure a single pill that contains two common drugs – a simple move that could save thousands of lives.
The condition is a key driver of heart attacks and strokes, affecting a third of adults. However, many people do not realise they have it as there are no early symptoms.
Yet fewer than 25 per cent of those being treated for high blood pressure have it under control – and research shows that is largely due to the fact that patients struggle to stick to a medication plan that involves taking multiple pills every day.
In a major clinical trial, 2,000 adults were given ‘polypills’ – tablets which contain more than one drug – that contained combinations of three commonly prescribed blood pressure medicines.
The drugs involved were perindopril, amlodipine and indapamide, and each of the pills contained two of the three, with all possible combinations used.
After six months, 70 per cent of the study participants no longer had high blood pressure, and four in ten had a totally normal, healthy reading. Every combination of the three drugs was equally successful.
At present, the NHS prescribing watchdog, the National Institute for Health and Care Excellence (NICE), doesn’t recommend polypills, but experts say that these convenient combo pills could revolutionise blood pressure care.
Cardiologist Dr Dorairaj Prabhakaran, professor of chronic disease control at the London School of Hygiene and Tropical Medicine, who led the study, said: ‘Some clinicians don’t like the idea of polypills – of not being able to adjust individual levels of medicines.
‘And drug companies don’t like them because they reduce profits – they’d rather sell two pills separately.
‘But they are a no-brainer for high blood pressure. We know they are effective. NICE really needs to reconsider its stance.’
Calls for cholesterol testing in your 20s
There were calls for people as young as 20 to be routinely tested for a hidden form of so-called ‘bad’ cholesterol, after two potential treatments were revealed at the conference.
One in five adults are thought to have raised levels of lipoprotein (a) – or Lp(a) – that, at high levels, dramatically increase the risk of a heart attack or stroke.
But despite a growing understanding of the danger it poses – the problem is believed to be genetic, rather than related to lifestyle – it’s not commonly checked for.
The main reason, say experts, is that until recently even if it was discovered there wasn’t much that could be done.
But that’s set to change, and several drug therapies designed to bring down Lp(a) levels are now in the pipeline.
Cardiologist Dr Rasha Al-Lamee said: ‘Once someone gets to 20, they should be offered a test – we need to know someone’s cardiovascular risk before heart disease develops.
‘Early detection allows prevention, even if that’s just triggering healthier behaviours. At the moment we are focused on fighting disease at the point where it’s probably too late to have much of an impact on life expectancy. We need to move the whole paradigm to finding and tackling things much earlier.’
Last week two potential new treatments for Lp(a) were unveiled. Muvalaplin comes in daily tablet form and a newly published study shows it reduces Lp(a) by up to 85 per cent in just four weeks.
The second, zerlasiran, is given via an injection once every six months. It’s a gene therapy which works by shutting off the production of a key protein needed to make Lp(a) – and research shows a single jab leads to an almost complete reduction.
Whether their effects lead to fewer heart attacks and strokes remains to be seen, but experts say an effective injection could have much wider benefits than daily tablets.
‘If you had something safe and easy to take, then starting early would become even more attractive,’ says Oxford University’s Professor Sir Rory Collins, whose pioneering research underpinned NHS statins guidelines. ‘By starting early you would see a massive effect on reduction in cardiovascular disease in the long term.’
In May the European Society of Cardiology issued guidance that every adult should be tested for Lp(a) at least once in their life. The US Food and Drug Administration is expected to rule on the issue next year.
12p-a-day drug to prevent heart failure
Further benefits of blood pressure pills were shown in a trial which revealed that one type of the medication could prevent heart failure from developing.
In an international study, led by Canadian experts, doctors gave the 12p-a-day pill, spironolactone, to patients who’d suffered a severe heart attack.
Heart failure is common after a heart attack, as the weakened organ struggles to pump blood around the body.
Spironolactone is a diuretic – it stimulates the kidneys to excrete water in urine, which in turn helps brings down blood pressure.
The trial found that after three years the patients were found to have a 38 per cent reduced risk of developing heart failure, compared with those who were not given the pill.
But one downside was that three in ten participants in the trial dropped out as they couldn’t tolerate the side effects of spironolactone, which include dizziness, nausea, cramps and breast pain or breast tissue growth in men.
However, experts say, based on these findings, policymakers should consider adding the drug to those offered as standard to patients after a severe heart attack. At present, recommended treatments include cholesterol-lowering statins, other types of blood pressure medication and anti-clotting drugs.
Texas-based cardiologist Dr Salim Hayek said: ‘We’ve been using spironolactone for a long time in patients with known heart failure. I also prescribe it to patients after a heart attack, and this study will hopefully provide evidence to all doctors that it should be offered more often.’
