GLP-1 medications for heart health: how these weight-loss drugs may reduce heart attack and stroke risk

If you’ve heard about GLP-1 medications, chances are it was in the context of weight loss.

These drugs have become widely known for helping people lose weight – and that association is so strong that it often overshadows everything else they do. But long before GLP-1s made headlines for weight loss, researchers were studying them for something even more important: protecting the heart.

Today, cardiologists are paying close attention because strong evidence shows GLP-1 medications can reduce the risk of heart attack, stroke, and death from heart disease – sometimes even in people who don’t have diabetes.

“Think “multi‑tool.” One medicine that helps with several risk factors at once: weight, blood sugar, inflammation, blood pressure, and how blood vessels relax. Together, these changes help protect the heart,” says Viet Le, DMSc, MPAS, PA-C, FACC, FAHA, HF-Cert, a preventive cardiology specialist at Intermountain Health.

How GLP-1 medications protect the heart, not just blood sugar

When GLP-1 medications were first studied, researchers mainly wanted to make sure they didn’t harm the heart. What they found was something much more promising.

Early trials in people with diabetes showed fewer major cardiovascular events. Later studies confirmed those benefits and expanded them to people without diabetes who still had elevated heart risk. 

“Several trials of GLP1s in patients with diabetes showed fewer heart events,” Le says. “Then a trial in patients without diabetes, but who were obese and at risk for heart disease, showed that semaglutide for chronic weight management also reduces heart events.”

NOTE: Semaglutide is the active medication in brand-name drugs like Ozempic®, Wegovy®, and Rybelsus®.

Those findings shifted GLP‑1s into prevention and led to updated FDA labeling for some GLP-1 medications, including use for cardiovascular risk reduction in certain patients without diabetes.

Why GLP-1 heart benefits go beyond weight loss

GLP-1s are often described as weight-loss shots, but cardiologists see them differently.

One key target is visceral fat, which is the fat that collects deep inside the abdomen around vital organs.

“It’s becoming more apparent how damaging visceral fat is,” Le says. “It contributes to diabetes, fatty liver disease, kidney disease, and cardiovascular disease. When you treat that upstream problem as GLP-1s do, you help protect the heart and reduce the risk of cardiovascular events.”

In other words, heart protection from GLP-1s isn’t just about the number on the scale. It’s about improving the underlying metabolic and inflammatory processes that drive heart disease.

Who may benefit from GLP-1 medications for heart disease prevention

GLP-1 medications aren’t for everyone, but evidence suggests several groups may see meaningful cardiovascular benefit:

• People with established cardiovascular disease, such as a prior heart attack, stroke, or blocked arteries
• People with type 2 diabetes or metabolic syndrome, a combination of risk factors like belly fat, high blood pressure, and high blood sugar
• People with obesity and multiple heart risk factors, even without diabetes

“If your 10-year heart risk is moderate to high, a GLP-1 may be one more way to lower that risk,” Le says.

How GLP-1 medications fit into a heart disease prevention plan

Despite their benefits, GLP-1s aren’t a replacement for the basics of heart care.

“They add to foundational prevention. They don’t replace it,” Le emphasizes. “We still focus on optimizing blood pressure, lowering LDL cholesterol, eating well, and staying active. GLP-1s work best when they’re layered on top of those strategies.”

This combined approach reflects a broader shift in cardiology: treating multiple risk factors together, earlier in life, rather than waiting for a heart event to occur.

Common misconceptions about GLP-1 medications and heart health 

As GLP-1 use has grown, so has confusion. Dr. Le often helps patients sort fact from fiction. Here are some of the most common myths:

“They’re just weight-loss shots.”

GLP-1s have been shown to reduce heart events and slow progression of conditions like kidney disease and fatty liver disease.

“They’re only for people with diabetes.”

Some benefits extend to people without diabetes who have obesity or other chronic conditions linked to heart disease.

“Everyone gets severe nausea.”

An upset stomach is usually temporary and manageable with slow dose increases, small meals, and hydration.

“I have to choose between GLP-1s and my other medications.”

In most cases, GLP-1s are part of a combined prevention plan.

How GLP-1 medications support early heart disease prevention

Perhaps the biggest shift GLP-1s enable is timing.

“They let us act earlier, in people with obesity or multiple risk factors, not just after diabetes or a heart event appears,” Le says. “That’s what real prevention looks like.”

By addressing risk sooner, clinicians can help reduce the likelihood of serious cardiovascular events for years down the road.

Questions to ask your doctor about GLP-1 medications for heart health

If you’re curious whether a GLP-1 medication could help protect your heart, Le recommends beginning with a few key questions:

• What is my 10-year heart disease risk?
• Am I a safe and appropriate candidate?
• What benefits should I expect, and how soon?
• What side effects should I watch for, and how do we manage them?
• How does this fit with my current medications, nutrition, and activity plan?

NOTE: GLP-1s aren’t recommended during pregnancy or for people with certain rare thyroid conditions, and your care team can help review your personal safety considerations.

The future of GLP-1 medications in heart health prevention

GLP-1 medications aren’t a shortcut, but for the right patients, they may be a powerful tool.

At Intermountain Healthcare, preventive cardiology focuses on treating risk early, using the best available science to protect long-term heart health. For some people, GLP-1s are becoming part of that picture – alongside movement, nutrition, sleep, and proven heart medications – to help lower risk before a heart attack or stroke ever happens.