By Victoria Stokes
If you have type 2 diabetes you’re probably aware that the condition puts you at an increased risk of developing heart disease.
Now, a new study has shown that a class of diabetes medications is associated with fewer major adverse cardiovascular events.
The study, conducted at Vanderbilt University Medical Center, found that GLP-1 drugs like Ozempic (semaglutide) resulted in lower instances of Major cardiovascular events (MACE) than DPP4 inhibitors (another type of diabetes drug) in older veterans with no prior heart disease.
The use of a GLP-1 receptor agonist was associated with a 20% reduced risk of MACE and heart failure hospitalization when compared to treatment with DPP4 inhibitors, which were regarded as neutral in respect to cardiac events.
In other words, these results translate to approximately three fewer heart failure, heart attack, or stroke events per 1,000 people using a GLP-1 medication for a year.
The study’s researchers say these findings will help clinicians in choosing a diabetes drug regimen for older patients.
Christianne Roumie, MD, MPH, professor of Medicine in the Division of General Internal Medicine and Public Health and senior author of the study, describes it as “an important contribution to patient care” and says it “adds to what we as clinicians know about treating diabetes and heart disease prevention.”
Why these medications may help reduce risks of adverse cardiac events
“GLP-1 inhibitors have emerged as a promising treatment option for individuals with type 2 diabetes, demonstrating not only effective blood sugar control but also additional benefits like weight loss and reduced risk of cardiovascular disease,” says Bari Stricoff, a registered dietitian at Well Easy.
According to Stricoff, the reason someone with type 2 diabetes might experience a reduced risk of cardiovascular disease when taking a GLP-1 drug compared to a DPP4 inhibitor hinges on the effects these drugs have on cardiovascular risk factors.
“GLP-1 receptor agonists not only lower blood sugar levels but also have additional cardiovascular benefits,” she points out.
“Firstly, obesity is a major risk factor for cardiovascular disease, and GLP-1 receptor agonists can promote weight loss by reducing appetite and increasing satiety,” Stricoff explains. “Secondly, some GLP-1 drugs have been shown to reduce blood pressure, which is an important cardiovascular risk factor.”
Additionally, Stricoff says some studies suggest GLP-1s have anti-inflammatory and anti-atherosclerotic effects, both of which can reduce the risk of cardiovascular disease.
“GLP-1 medications can also have a positive effect on lipid profiles, such as reducing triglyceride levels, which may contribute to a reduced risk of cardiovascular events,” Stricoff adds.
Similarly, Crystal Scott, a registered dietitian at Top Nutrition Coaching, says the results of this study are consistent with previous evidence on the links between GLP-1 drugs and cardiovascular health in people with type 2 diabetes.
Like Stricoff, she points to the cardioprotective effects of GLP-1s, noting how these drugs can improve endothelial function, reduce arterial stiffness, and decrease inflammation, all of which can contribute to the development and progression of cardiovascular disease.
The findings from the study are promising but more research is needed
“It’s important to note that the study was retrospective and observational, so it cannot establish causality or rule out potential confounding factors,” she points out.
“Future randomized controlled trials are needed to confirm these findings and to determine how these medications can be used optimally to prevent cardiovascular disease in people with type 2 diabetes,” she surmises.
Additionally, Scott notes that the study population consisted of U.S. veterans, so the results may not be generalizable to other populations.
Furthermore, the study did not examine the long-term safety and efficacy of these medications, she points out.
Other ways you can improve your heart health without medication
While the links between GLP-1 drugs and reduced risk of adverse heart health are promising, Stricoff says, it is crucial to recognize that these medications primarily address the symptoms and consequences of type 2 diabetes rather than the root causes of the disease.
“While GLP-1 inhibitors can be life-changing for some patients, they should be considered as part of a comprehensive treatment plan that includes nutrition education and behavioral interventions to promote long-term health and wellness,” she surmises.
So, GLP-1s aside, what else can you do to improve your heart health?
Stricoff says lifestyle factors play an important role.
“Unhealthy lifestyle choices, such as a poor diet, physical inactivity, and smoking, are common risk factors for both type 2 diabetes and heart disease, and these factors can exacerbate the risk of developing heart disease in people with diabetes,” she explains.
What’s more, she says it’s crucial to pair GLP-1 inhibitor therapy with interventions that target the root causes of type 2 diabetes and promote long-term behavior change.
“Nutrition education is a vital component of this approach, as it empowers patients to make informed decisions about their food choices, understand the impact of diet on their health, and adopt healthier eating habits that can be sustained even in the absence of medication,” she surmises.
Specifically, Scott advises following a diet that is low in saturated and trans fats, sodium, and added sugars, and high in fiber, whole grains, fruits, and vegetables.
She also recommends engaging in regular physical activity, such as brisk walking, cycling, swimming, or dancing, for at least 150 minutes per week.
Medications often come with a long list of scary side effects, so it’s certainly promising that GLP-1 drugs are linked with a lower risk of adverse cardiac events. The results of this study may help your clinician choose an appropriate treatment for you.
However, effective as these drugs may be, both experts agree, you shouldn’t neglect the basics: eat well, move more, and quit smoking.
Source: Healthline
