GLP-1 medications for heart health: why cardiologists see them as more than a weight loss drug

If you’ve heard about GLP-1 medications, it probably wasn’t in a cardiology office.

More likely, it was in a headline. Or a social media post. Or a side conversation about weight loss, diabetes, or whether these drugs are “worth it.”

What’s often missing from those conversations is how heart doctors are thinking about GLP-1s and why some of them believe these medications are changing the way heart disease is treated and prevented.

For Intermountain Health interventional cardiologist Dr. Brian Allen, the shift has been hard to ignore.

“Everything that I treat as a cardiologist is treated in large part by weight loss and by control of diabetes,” he said, noting strong evidence that GLP-1s reduce major cardiac risk.

From his perspective, GLP-1s are about changing the conditions that make heart disease so common in the first place.

How GLP-1 medications became part of heart disease prevention

When GLP-1 medications first entered the picture, researchers were cautious. The early question was whether they might harm it.

What followed surprised a lot of people.

Early trials in patients with diabetes showed fewer serious heart-related events. Later studies went a step further, showing similar benefits in people without diabetes who still had higher heart risk.

“Several trials of GLP-1s in patients with diabetes showed fewer heart events,” Dr. Allen said. “Then a trial in patients without diabetes, but who were obese and at risk of heart disease, showed that semaglutide for chronic weight management also reduces heart events.”

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

For Dr. Allen, those findings changed how he thought about the role these medications could play.

“These findings opened the door to using GLP-1s as a cardiovascular drug – not just a diabetes drug,” Allen said. “The most impactful point to me, is that by the data these medications can be considered comparably effective as statins in reducing risk of cardiac events.”

That comparison matters. Statins are medications that help lower “bad” LDL cholesterol and reduce inflammation in blood vessels. They’ve been used for decades to help prevent heart attacks and strokes and are considered a cornerstone of heart disease prevention.  

Why GLP-1 heart benefits go beyond weight loss

GLP-1 medications are often talked about as “weight-loss drugs,” and Dr. Allen understands why. Weight loss is one of the most visible changes patients experience.

But in cardiology, weight is deeply tied to the conditions that strain the heart over time.

Excess weight contributes to high blood pressure, high cholesterol, sleep apnea, coronary artery disease, and heart failure – problems Dr. Allen treats every day. When weight comes down, many of those risks decrease.

To help patients understand this, Dr. Allen often uses an analogy. 

Asking someone to suddenly become more active without addressing excess weight, he says, is like asking them to do squats while carrying a 45-pound plate.

“It’s tone deaf for me to say ‘Well, get out there and go jog’ when someone has that extra kind of weight on,” Dr. Allen said. “If I can kickstart the process with weight loss with these medications, then now they are on the other side of it, and I can help them be more active.”

In that sense, weight loss isn’t the end goal. It’s a way to make other heart-healthy behaviors safer, more realistic, and more sustainable. 

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

GLP-1 medications aren’t for everyone, and Dr. Allen doesn’t see them as a permanent solution for most patients, except for those managing diabetes.

Instead, he views them as another tool that can help some patients lower risk earlier, especially those managing obesity along with other heart-related risk factors.

For many patients, the longer-term focus becomes maintaining progress through lifestyle changes – better nutrition, more physical activity, and ongoing care – after the medication has helped create momentum.

Dr. Allen is also clear that these medications should never be taken without medical supervision.

There are rare but important risks, including concerns for people with certain genetic cancer syndromes, gallbladder disease, or severely uncontrolled diabetes. That’s why conversations with a healthcare provider are essential before starting treatment. 

Muscle loss and strength considerations when using GLP-1 medications

Another part of the conversation Dr. Allen has with patients is about muscle.

With current GLP-1 medications, rapid weight loss can include muscle loss as well as fat. Dr. Allen notes that as much as 20% of each pound lost may come from muscle.

Future medications in development aim to address this, but for now, he encourages patients to be proactive by prioritizing protein intake and strength training as weight comes off. 

The future of GLP-1 medications in heart disease care

The GLP-1 landscape is expanding quickly. More than 40 medications and related agents are currently in development, with researchers studying their potential far beyond diabetes, heart disease, sleep apnea, and fatty liver disease.

Access is changing, too. While GLP-1 medications were once out of reach for many patients, manufacturer programs and discounts are starting to shift affordability, opening doors that didn’t exist just a few years ago.

Intermountain Health’s preventive approach to heart health

At Intermountain Health, heart care is shaped by clinicians who follow guidelines – and help push them forward. Cardiologists like Dr. Allen pay close attention to emerging research, ask hard questions about what it really means for patients, and adjust care when the evidence points to something better.

For patients, that commitment to learning matters. It means conversations about heart health are informed by the latest science and by doctors who care deeply about finding better ways to reduce risk earlier, not just treat disease later.

The most important first step is still a conversation. Talk with your provider about your heart risk, your goals, and what options make sense for you. Visit our Health & Vascular page to learn more.