CirculationJul 6, 2026

Lowering Heart Disease Risk with GLP-1 Receptor Agonist Drugs

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jul 7, 2026

Abstract

GLP-1 receptor agonists have been shown to reduce major adverse cardiovascular events, including myocardial infarction and stroke.

GLP-1 receptor agonists enhance insulin secretion and reduce appetite, contributing to weight loss and improved blood sugar levels.
These agents improve vascular function and reduce inflammation and oxidative stress in the heart.
Large randomized trials indicate a consistent reduction in cardiovascular events among diverse populations treated with GLP-1 receptor agonists.
Emerging therapies that target multiple incretin pathways could further enhance the cardiovascular benefits associated with GLP-1 receptor agonists.
GLP-1 receptor agonists appear to positively influence various cardiometabolic processes, potentially improving overall metabolic health.

Simplified

GLP-1 (glucagon-like peptide-1) receptor agonists (RAs) have emerged as a major therapeutic advance in cardiometabolic medicine. Initially developed as glucose-lowering therapies for type 2 diabetes, these agents have demonstrated broad benefits that extend well beyond glycemic control. GLP-1 RAs enhance glucose-dependent insulin secretion and reduce appetite, leading to improved glycemia and sustained weight loss. In addition, GLP-1 signaling exerts vascular and myocardial effects, including improved endothelial function, reduced inflammation and oxidative stress, and favorable changes in cardiac metabolism and remodeling. Large randomized cardiovascular outcomes trials have consistently shown that several GLP-1 RAs reduce major adverse cardiovascular events, including myocardial infarction, stroke, cardiovascular death, and heart failure. Benefits have been observed across diverse populations, including individuals with established cardiovascular disease and those with obesity but without diabetes. Emerging therapies targeting multiple incretin pathways, such as dual GIP (glucose-dependent insulinotropic polypeptide)-GLP-1 RAs, may further extend these benefits. Collectively, these findings suggest that GLP-1 RAs influence multiple cardiometabolic pathways and may shift the underlying metabolic milieu toward a more favorable physiological state. In this Clinical Primer, we review the physiology of GLP-1 signaling, the evidence supporting cardiovascular risk reduction, and practical considerations for the clinical use of incretin-based therapies.

Full Text

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Funding

Competing interests

Dr Gerstein holds the McMaster-Sanofi Population Health Institute Chair in Diabetes Research and Care. He reports research grants from Novo Nordisk, Sanofi, AstraZeneca, and Eli Lilly; honoraria for speaking from Jiangsu Hanson; consulting fees from Abbott, Hanmi, Eli Lilly, Novo Nordisk, and Sanofi; and payments to his institution for continuing medical education from Abbott, Boehringer-Ingelheim, Eli Lilly, Novo Nordisk, and Sanofi. The other author reports no conflicts.

PubMed

Lowering Heart Disease Risk with GLP-1 Receptor Agonist Drugs

Abstract

Full Text

Funding

Competing interests

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