Beyond weight loss: How Semaglutide cuts heart risk faster than the scale moves – The Times of India
Doctors often prescribe semaglutide to help people manage type 2 diabetes or drop extra weight. Lately, though, its knack for shielding the heart has cardiologists buzzing. A deep dive into the SELECT trial reveals benefits that show up fast and stick around, even if the scale barely budges. This shift could change how we tackle heart risks in everyday patients.
Digging into the select trial
Researchers kicked off the SELECT trial back in 2018.It pulled in 17,604 adults from 41 countries, all carrying extra weight or obesity alongside proven cardiovascular disease, but no diabetes diagnosis. Ages ranged from 45 to 75, with people showing at least one prior heart event like a heart attack or stroke. Half received weekly 2.4 mg injections of semaglutide, the rest a placebo, alongside routine care for cholesterol, blood pressure–and lifestyle advice.The trial wrapped data collection in 2023, with full follow-up through June 2024. Over nearly three years, the semaglutide group saw a 20 percent drop in major adverse cardiovascular events, or MACE.That covers nonfatal heart attacks, nonfatal strokes, and deaths from heart or vessel issues. Numbers tell a clear story: 6.5 percent in the drug group hit MACE versus 8 percent on placebo. Heart deaths alone fell 15 percent.
Quick wins puzzle experts
What floors doctors most is the timing. Benefits emerged within eight weeks for some endpoints, well before peak weight loss or steady dosing. Average weight drop hit 10 percent by month 20, yet heart protection started sooner. The University College London team, led by John Deanfield, crunched numbers on waist reduction. It accounted for just 30 to 38 percent of the gains at two years.Even people losing under five percent body weight enjoyed full benefits, matching those who shed more. This held across body sizes, from BMI 27 to over 50. Deanfield called it surprising, saying it points to direct heart-friendly actions.
How Semaglutide works its magic
Semaglutide mimics GLP-1, a gut hormone that curbs hunger and steadies blood sugar. For hearts, it likely dials down inflammation in arteries, eases plaque buildup, and improves vessel function. It also tweaks blood pressure and lipids positively, beyond calorie cuts. Animal studies hint at less heart muscle scarring post-attack.In obese patients, chronic low-grade inflammation fuels heart woes. Semaglutide tempers that fire early. One analysis showed steady drops in C-reactive protein, a key inflammation marker, from week four. Blood pressure eased too, by about 3 mmHg systolic on average.
Real world ripples for India
Heart disease strikes Indians a decade earlier than Westerners, often tied to belly fat and diabetes clusters.With obesity climbing in urban spots like Delhi-and Mumbai, semaglutide fits preventive playbooks. SELECT excluded diabetics, so it spotlights obese heart patients broadly.Guidelines from American College of Cardiology already nod to GLP-1 drugs for high-risk cases. Indian doctors eye it for those post-heart event with BMI over 27. Cost stays a hurdle though, around Rs 10,000 monthly, but generics loom. Side effects hit gut mostly: nausea in 20 percent early on, dropping later.Gallbladder issues popped up more, but no excess pancreatitis or thyroid cancers.
Steps ahead
SELECT paves way for trials like SOUL, testing oral versions in broader groups. Researchers probe combos with statins or blood thinners. For now, it urges chats with heart specialists before starting-especially with kidney tweaks or family thyroid history.This breakthrough reminds us treatments often multitask. Semaglutide started as a diabetes helper, became a weight tool, now guards hearts directly. Patients gain options to dodge that next scare, blending meds with walks-and veggie plates. As data piles up, expect it in more toolkits worldwide.
