NutrientsJun 12, 2026

GLP-1 Drugs for Recovering Heart Failure Patients: How They Work, Clinical Results, and Future Directions

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Jun 13, 2026

Abstract

Heart failure with preserved ejection fraction (HFpEF) is increasingly prevalent and challenging to treat.

GLP-1 receptor agonists (GLP-1RAs) may provide cardiometabolic benefits beyond glucose lowering in patients with HFpEF.
Obesity is a significant factor in the development of HFpEF, and GLP-1RAs promote weight loss and improve metabolic abnormalities associated with this condition.
The advantages of GLP-1RAs appear to be more pronounced in patients with HFpEF compared to those with heart failure with reduced ejection fraction.
Current guidelines suggest using GLP-1RAs for patients with type 2 diabetes and cardiovascular disease, with growing recognition of their benefits in obese patients with HFpEF.
Resistance training is essential in cardiac rehabilitation for older patients with HFpEF due to the common occurrence of sarcopenia, which negatively impacts outcomes.
The most common adverse effects of GLP-1RAs are gastrointestinal, typically mild to moderate but potentially leading to treatment discontinuation.

Simplified

Heart failure (HF) remains associated with high morbidity and mortality, with heart failure with preserved ejection fraction (HFpEF) becoming increasingly prevalent and therapeutically challenging despite advances in pharmacological and rehabilitative care. Beyond their glucose-lowering effects, glucagon-like peptide-1 receptor agonists (GLP-1RAs) confer cardiometabolic benefits and may serve as effective adjuncts to cardiac rehabilitation (CR), particularly in obese patients with HFpEF. Obesity plays a central role in the pathophysiology of HFpEF, and GLP-1RAs promote weight loss, reduce insulin resistance and leptin signaling, and improve hemodynamic and metabolic abnormalities associated with HFpEF. Accumulating evidence suggests that the benefits of GLP-1RAs are phenotype-specific and more pronounced in patients with HFpEF than in patients with HF with reduced ejection fraction. Current clinical guidelines recommend GLP-1RAs for patients who have type 2 diabetes mellitus and established cardiovascular (CV) disease or are at high CV risk, with recent updates recognizing their potential benefits in patients with HFpEF and obesity. Cardiac rehabilitation, delivered through multidisciplinary programs, remains a cornerstone of HF management. Although caloric restriction and aerobic exercise can be beneficial in patients with HFpEF and obesity, these interventions alone are often insufficient. Sarcopenia is common in older patients with HFpEF and contributes to adverse outcomes, underscoring the importance of incorporating resistance training into CR programs. The most frequent adverse effects of GLP-1RAs are gastrointestinal events, which are generally mild to moderate but may lead to treatment discontinuation in some patients. Future studies should investigate the potential synergistic effects of GLP-1RAs and CR, clarify their long-term safety and efficacy in HF populations, and define their role beyond obese HFpEF phenotypes.

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Funding

Competing interests

The authors declare no conflicts of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript; or in the decision to publish the results.

PubMed

GLP-1 Drugs for Recovering Heart Failure Patients: How They Work, Clinical Results, and Future Directions

Abstract

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Abstract

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