Diabetes, obesity & metabolismJan 21, 2026

GLP-1 receptor drugs and heart health in Asian, Black, and White people: Updated analysis including the SOUL trial

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗OA ↗

Updated Jan 22, 2026

Abstract

A total of 8164 Asian, 4036 Black or African American, and 62,503 White participants were included in the analysis of cardiovascular risk reduction associated with glucagon-like peptide-1 receptor agonists (GLP-1RAs).

GLP-1RAs significantly reduced major adverse cardiovascular events (MACE) risk in Asian populations (HR 0.73; p < 0.001).
MACE risk was also reduced in White populations (HR 0.86; p < 0.001).
In Black or African American populations, the reduction in MACE risk was similar to White populations (HR 0.88) but did not reach statistical significance (p = 0.34).
The relative risk reduction for MACE was significantly greater in Asian populations compared to White populations (RHR 0.84; p = 0.027).
Point estimates suggested a favoring trend for Asian populations compared to Black or African American populations, though not statistically significant (RHR 0.81; p = 0.25).

Simplified

AIMS: To evaluate the cardiovascular efficacy of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in Asian, Black or African American, and White populations, and to assess whether the magnitude of cardiovascular risk reduction differs across these populations.

MATERIALS AND METHODS: PubMed and EMBASE were searched to 11 November 2025 for randomized placebo-controlled GLP-1RA trials in adults with type 2 diabetes or overweight/obesity that reported race-stratified major adverse cardiovascular events (MACE; cardiovascular death, non-fatal myocardial infarction, or non-fatal stroke). Hazard ratios (HRs) for MACE were extracted for Asian, Black or African American, and White populations. Random-effects meta-analyses were used to obtain pooled HRs and ratios of HRs (RHRs) comparing treatment effects between populations.

RESULTS: Nine trials, including the recent SOUL trial, were included, comprising 8164 Asian, 4036 Black or African American, and 62 503 White participants. GLP-1RAs reduced MACE risk in Asian (HR 0.73; 95% CI 0.63-0.85; p < 0.001) and White populations (HR 0.86; 95% CI 0.81-0.91; p < 0.001). In Black or African American populations, the effect was similar to that in White populations (HR 0.88; 95% CI 0.67-1.15; p = 0.34) but did not reach statistical significance. The pooled RHR for Asian versus White populations was 0.84 (95% CI 0.71-0.98; p = 0.027), indicating a significantly greater risk reduction in Asian populations. The RHR for Asian versus Black or African American populations was 0.81 (95% CI 0.57-1.16; p = 0.25), with point estimates favouring Asian populations.

CONCLUSIONS: GLP-1RAs reduced MACE risk across populations, with greater relative risk reduction in Asian populations and broadly similar benefits in Black or African American and White populations.

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Funding

Competing interests

Daisuke Yabe received clinically commissioned or joint research grants from Novo Nordisk, Ono Pharmaceutical, Taisho Pharmaceutical, Terumo, and Arklay. Daisuke Yabe also received consulting or speaker fees from Sumitomo Dainippon Pharma, Boehringer Ingelheim, Astellas Pharma, MSD, Novo Nordisk, Ono Pharmaceutical, Eli Lilly, and Takeda Pharmaceutical. Satoshi Yoshiji serves as a consultant to the Broad Institute of MIT and Harvard through Precision Global Consulting and to PriveBio, Inc., unrelated to this project. All other authors declare no conflicts of interest.

PubMed

GLP-1 receptor drugs and heart health in Asian, Black, and White people: Updated analysis including the SOUL trial

Abstract

Full Text

Funding

Competing interests

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