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Lancet Analysis: Semaglutide Cuts Major Heart Events Regardless of Weight Loss

The finding strengthens the case for prescribing GLP-1 drugs based on cardiovascular risk rather than weight alone.

Overview

  • Across the SELECT trial’s 17,604 adults with overweight or obesity and established cardiovascular disease in 41 countries, semaglutide lowered major adverse cardiovascular events by about 20% versus placebo.
  • The cardioprotective effect was consistent across baseline BMI groups, including participants around BMI 27, and was largely unrelated to how much weight was lost early in treatment.
  • Reduction in waist circumference explained roughly one-third of the observed benefit, highlighting the particular importance of central adiposity in heart risk.
  • Authors and outside experts say the results support broader use beyond strict BMI cutoffs, with ongoing NHS rollout plans and clinical guidelines likely to weigh these data.
  • The prespecified analysis was published in The Lancet and funded by Novo Nordisk; researchers noted under-representation of women and non-white participants and called for more data on mechanisms, long-term safety and applicability to other GLP-1 therapies.