The American journal of cardiologyOct 9, 2026

How Social and Economic Disadvantages Relate to Heart Failure Treatment Results with GLP-1 Medicines

GLP-1 Therapies Weekly Brief ↗PubMed ↗DOI ↗

Updated Oct 10, 2026

Abstract

GLP-1 receptor agonist therapy was associated with similar relative reductions in all-cause mortality or hospitalization for both socioeconomically deprived and non-deprived patients.

Among socioeconomically deprived patients, GLP-1 receptor agonist users had a mortality and hospitalization risk reduction (adjusted hazard ratio 0.68).
Deprived patients experienced worse outcomes compared to non-deprived patients, with a 35.5% event rate versus 27.1% (adjusted hazard ratio 1.50).
Higher rates of hospitalization (adjusted hazard ratio 1.53) and mortality (adjusted hazard ratio 1.13) were observed in deprived GLP-1 receptor agonist users.
Increased risks of heart failure exacerbation (adjusted hazard ratio 1.11) and ischemic stroke (adjusted hazard ratio 1.16) were noted in the deprived group.
Despite similar relative benefits from GLP-1 receptor agonist therapy, deprived patients faced higher absolute rates of adverse outcomes.

Simplified

The impact of socioeconomic deprivation on the effectiveness and safety of glucagon-like peptide-1 receptor agonists (GLP-1RAs) in heart failure (HF) remains unclear. We evaluated GLP-1RA-associated outcomes across socioeconomic strata and quantified residual disparities among GLP-1RA users. Using the TriNetX Global Network (2020-2024), adults with HF initiating GLP-1RA therapy were categorized as socioeconomically deprived or non-deprived. Cohorts were 1:1 propensity-score matched within each stratum, enabling three comparisons: GLP-1RA users vs non-users in deprived patients, GLP-1RA users vs non-users in non-deprived patients, and deprived vs non-deprived among GLP-1RA users. Cox models estimated adjusted hazard ratios (aHRs) for 12-month mortality and hospitalization outcomes. Among deprived patients, GLP-1RA users (n=22,585) were compared with non-users (n=194,967); among non-deprived patients, users (n=116,439) were compared with non-users (n=2,254,050). In a direct comparison restricted to GLP-1RA users, deprived (n=21,171) and non-deprived (n=104,887) patients were analyzed. GLP-1RA therapy was associated with similar relative reductions in all-cause mortality or hospitalization in deprived (aHR 0.68, 95% CI 0.66-0.70) and non-deprived patients (aHR 0.68, 95% CI 0.67-0.69). However, deprived users had worse outcomes than non-deprived users (35.5% vs 27.1%; aHR 1.50, 95% CI 1.44-1.55), driven by higher hospitalization (aHR 1.53, 95% CI 1.48-1.58) and mortality (aHR 1.13, 95% CI 1.02-1.24). HF exacerbation (aHR 1.11) and ischemic stroke (aHR 1.16) were also increased. GLP-1RA use was associated with similar relative reductions in adverse outcomes across socioeconomic groups; however, socioeconomically deprived patients continued to experience higher absolute event rates, likely reflecting persistent baseline disparities and residual risk.

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How Social and Economic Disadvantages Relate to Heart Failure Treatment Results with GLP-1 Medicines

Abstract

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