Cardiac failure reviewNov 14, 2025

How Glucagon-like Peptide-1 Receptor Agonists May Help Heart Failure: How They Work, Evidence, and Finding the Best Patients

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

Updated Jun 27, 2026

Abstract

Essence

GLP-1 receptor agonists appear most supported for heart failure with preserved ejection fraction in patients with obesity, with or without type 2 diabetes.

Evidence

This review synthesizes cardiovascular outcome trials and dedicated trials, noting improvements in weight, heart failure symptoms, and heart failure events in some studies.

Caveat

The reviewed evidence does not support GLP-1 receptor agonists solely for heart failure with reduced ejection fraction.

Simplified

Glucagon-like peptide-1 receptor agonists (), established treatments for type 2 diabetes and obesity, exhibit cardiovascular benefits extending to heart failure (HF) with preserved ejection fraction (). Mechanisms contributing to HF improvement include significant weight loss, blood pressure reduction, enhanced glycaemic control, anti-inflammatory effects and potential direct cardioprotective and vascular actions. Although cardiovascular outcome trials provided initial positive signals, dedicated HFpEF trials confirmed the efficacy of GLP-1RAs in HFpEF patients with obesity and/or diabetes. In some trials, GLP-1RAs significantly improved weight, symptoms of HF and HF events. Current evidence strongly supports GLP-1RAs in patients with HFpEF and obesity, with or without type 2 diabetes. The data do not support their use solely for HF with reduced ejection fraction.

Key numbers

3–5 kg

Weight Loss with

Weight loss achieved with shorter-acting .

7.8 points

KCCQ-CSS Improvement

Change in KCCQ-CSS in the STEP- trial vs. placebo.

33%

Hospitalization Risk Reduction

Relative risk reduction in the SUMMIT trial.

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Funding

Competing interests

Disclosure: MA has received speaker honoraria from AstraZeneca, Bayer, Boehringer Ingelheim, Novartis and Pfizer. All other authors have no conflicts of interest to declare.

PubMed

How Glucagon-like Peptide-1 Receptor Agonists May Help Heart Failure: How They Work, Evidence, and Finding the Best Patients

Abstract

Key numbers

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Funding

Competing interests

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Abstract

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Funding

Competing interests

Related papers

You found one interesting study. We’ll send the next 7.

What Lands in Your Inbox Each Week:

Recent issues from the glp-1 therapies brief