By Dr Thomas Heseltine, Consultant Cardiologist at Venturi Cardiology
Over the past few years, there’s been a seismic shift in the conversation around obesity and cardiovascular health, and much of it is down to the rise of injectable weight loss medications like semaglutide (Wegovy) and tirzepatide (Mounjaro). While initially developed to treat type 2 diabetes, these GLP-1 based medications have become widely discussed for their potential to support significant, sustained weight loss. But beyond the headlines and hype, what do they mean for heart health?
At Venturi Cardiology, we’re seeing more patients asking about whether these drugs can reduce their cardiovascular risk. It’s a fair question. As cardiologists, we’ve long known that carrying excess weight—particularly around the midsection—raises the risk of high blood pressure, abnormal cholesterol levels, type 2 diabetes, coronary artery disease, and heart failure. Reducing that risk, especially in people with early metabolic dysfunction, is central to the kind of preventative care we advocate every day.
So here’s the truth: the evidence is starting to back up the idea that GLP-1 medications may directly benefit the heart, and not just via the route of weight loss.
What Are These Medications, and How Do They Work?
GLP-1 receptor agonists like semaglutide work by mimicking the action of a gut hormone that regulates appetite, blood sugar, and insulin. They effectively reduce hunger, improve satiety, and lead to significant reductions in body weight over time. Tirzepatide, a newer dual agonist, targets two hormones and appears to have even greater effects on weight loss.
In clinical settings, we’re now routinely seeing 10–20% weight reductions over 12 to 18 months—numbers we previously only associated with bariatric surgery.
The Heart Health Angle: What the Studies Say
One of the most important pieces of evidence we have is the SELECT trial, published in 2023. In this study of over 17,000 people with overweight or obesity and pre-existing heart disease, semaglutide reduced the risk of major cardiovascular events (including heart attack, stroke, or cardiovascular death) by 20%.
That’s a big number—and it’s the first time we’ve seen a weight loss medication demonstrate such a clear and independent benefit to heart health.
On top of that, patients on GLP-1 therapies tend to experience improvements in blood pressure, cholesterol, insulin sensitivity, and levels of systemic inflammation. We’re also seeing early imaging data suggesting reductions in visceral fat and even epicardial fat—the fat surrounding the heart itself, which is linked to cardiomyopathy and heart failure risk.
Should You Consider These Medications?
For many patients struggling with their weight despite lifestyle changes, these medications offer a powerful new option. But like any treatment, they’re not for everyone. Common side effects include nausea, gastrointestinal upset, and less commonly, gallstones and pancreatitis. They’re also not currently available through the NHS for cardiovascular prevention alone, and costs can be a barrier in private practice.
At Venturi, we don’t offer these medications as a quick fix. Instead, we consider them as part of a broader strategy that includes:
• Personalised cardiovascular risk assessment
• Advanced imaging (including echocardiography and CT coronary angiography)
• Blood pressure and lipid optimisation
• Lifestyle support
Final Thoughts
There’s no question that injectable weight loss drugs are changing the landscape of cardiovascular prevention. But they’re not a silver bullet. Sustainable heart health still depends on a foundation of regular physical activity, good nutrition, and ongoing risk factor management.
If you’re concerned about your weight or your heart health, don’t wait. A consultation with one of our cardiologists can help clarify your risk, guide investigations, and, if appropriate, explore treatment options that make sense for you.
At Venturi Cardiology, we believe prevention is better than cure. And in this new era of metabolic medicine, that belief is more relevant than ever.
For more information on our services, or to book an appointment, get in touch: 01925 748 245
