How weight-loss drugs can cut your heart attack risk – even if you’re not overweight

view original post

If you’re one of the estimated 2.5 million people in Britain using weight loss jabs, there was good news last week.

According to new research, the injections not only offer you a slimmer figure but also significantly cut your risk of heart disease and stroke. In fact, even if you aren’t overweight, the study suggests that taking GLP-1 drugs such as semaglutide (known better by brand names Ozempic and Wegovy) and Tirzepatide (known commonly as Mounjaro) is likely to make you a great deal healthier.

Given that there are more than 7.6 million people living with a cardiovascular disease in the UK according to the British Heart Foundation, this could represent a major breakthrough for public health and the NHS.

Some experts have suggested it completely reframes the way in which so-called weight loss jabs are used and could be the most significant advance in fighting heart disease since the introduction of statins in the 1990s.

b’

‘

So how exactly do the injections improve heart health, and how else might doctors prescribe them in the future? Here’s what we know.

Heart health benefits are independent of weight loss

The research was conducted by University College London (UCL), examining data from over 17,000 people across 41 countries. Subjects were all over 45 and had a body mass index (BMI) of 27, which is the national average for adult Brits.

All of them had a history of cardiovascular illness. Previous studies had found a 20 per cent reduction in major adverse cardio events (“MACE”) amongst overweight people who used the drug to slim down.

In other words, the heart health benefits were considered a natural side effect of weight loss.

But the new research suggests something more profound. One third of participants experienced a reduction in their waistline (a key risk marker for heart attack and stroke), but even the two-thirds who didn’t experience the same reduction still saw their heart health improve anyway.

“Semaglutide benefitted people’s heart health unrelated to the amount of weight they lost,” says lead author of the research, Prof John Deanfield of UCL’s Institute of Cardiovascular Science.

“This reframes the way in which we see these drugs. They are much more interesting and beneficial than simply weight loss jabs. They have the potential to fight many different diseases by reducing chronic inflammation.”

Weight-loss drugs are fighting inflammation

Semaglutide and tirzepatide are known to reduce our consumption of food by mimicking GLP-1, a hormone your gut releases naturally to slow digestion and tell your brain that you are full. This study suggests there might be something else at play.

“They are fighting chronic inflammation in the body, but we don’t know exactly how yet,” says Prof Deanfield. “That’s what makes it so interesting.”

Acute inflammation is one of the body’s most vital defences against infection and injury. But chronic inflammation is a long-term immune response in which the body keeps releasing inflammatory chemicals long after an infection or injury has passed, causing a slow burn of internal damage that erodes tissues, disrupts organs, and fuels diseases like heart disease, diabetes, Alzheimer’s, arthritis and even depression.

“Most of the common diseases we hope to avoid as we get older are linked to inflammation in some way,” says Prof Deanfield. “Now we have seen the impact these drugs have on cardiovascular inflammation, it is easy to imagine they could help fight other diseases too. It could represent the biggest medical breakthrough in recent decades.”

Eat less, live longer

All the benefits of these drugs may be linked to simply eating less food. “Most of us eat too much sugar, too much salt and too large portions,” says Dr Pauline Swift, consultant nephrologist and chair of CASHH (Consensus Action On Salt, Sugar And Health).

“These are huge factors in all forms of inflammatory disease. By simply reducing our appetite for large amounts of junk food, these drugs are helping our bodies prevent disease. We don’t yet know if the drugs have a more direct effect on inflammation but, in the meantime, it doesn’t matter. We just know it works.”

b’

‘

Weight-loss drugs could revolutionise our health

“This is the easiest way to get people to look after themselves better,” says Dr Swift. “Lots of people are useless at taking their medications. They don’t take their blood pressure drugs or their statins, even if you tell them it will keep them alive.

“But with weight loss jabs people will continue to take them even when the side effects are bad. Many of my patients will suffer nausea, diarrhoea, constipation and vomiting but are willing to keep going for the weight loss benefits.

“But we know these drugs will also help bring down their blood pressure, reduce the risk of kidney disease and cardiovascular disease. They can save lives – and unlike other medicines, they sell themselves. People will do anything to get their hands on them.”

So should we all be taking them?

Cardiology guidelines already allow the use of semaglutide and tirzepatide for patients at risk of heart disease. Dr Swift also prescribes them for patients at risk of kidney disease, due to their ability to reduce blood pressure.

“I also occasionally prescribe them to young people who are presenting with very high blood pressure or obesity in order to cut their risk of cardio disease,” she says. Soon, says Prof Deanfield, we might see them similarly prescribed to patients at risk of numerous inflammatory diseases, including Crohn’s, Alzheimer’s and even gum disease.

“Research into all of these diseases, and how these drugs can help fight them, is ongoing,” he says. “Once the data is published, there will likely be a big increase in prescriptions.” The National Institute for Care and Health Excellence (NICE) has been cautious in rolling out the use of the drugs on the NHS.

The drugs are expensive and reserved for those with the “highest clinical need.” This means a BMI of 30 or higher, or 27 if you also have at least one major weight-related risk factor, such as diabetes, heart disease, or hypertension. New research is likely to loosen the criteria.

“Although it might cost the NHS a lot of money, it is likely to save it even more in the long term,” says Prof Deanfield. “Not just because it will reduce the strain on hospitals, but also because it could improve the wider economy.

“Millions of work days are missed due to illness. These drugs could reduce that and boost productivity very quickly.”

The Health Secretary is championing wider availability of the drugs, saying last month: “The wealthy talk about how they’ve transformed their health, their confidence, their quality of life. But what about the millions who can’t afford them?

“Obesity is closely related to many forms of cancer,” says Prof Deanfield. “So these drugs can at least have an indirect impact on fighting that too.”

There is a growing amount of evidence that weight loss jabs can help people curb their use of alcohol, cigarettes and narcotics. They have also been linked to a reduction in the symptoms of ADHD.

What are the risks of weight-loss drugs?

The known side effects of GLP-1 drugs include gastrointestinal issues (nausea, vomiting, diarrhoea) and, less commonly, severe illnesses such as gallbladder disorder and acute pancreatitis.

While there were some concerns that the drugs increased the risk of pancreatic cancer, studies of long-term users of the drugs (over seven years) found no evidence to support this.

“These drugs were first trialled in the early Noughties for diabetes patients,” says Prof Deanfield. “There is almost twenty years of data to support their safety.”

However, most studies have concluded that further research and patient monitoring are necessary to confirm the long-term risks. “We must be vigilant,” says Deanfield.

“But the evidence we currently have tells us that the risks are small in comparison to the benefits. These are expensive drugs, but they could save the NHS billions if they reduce the incidence of inflammatory diseases. They could also boost the economy by reducing the number of work days lost to illness.”

How will they change healthcare?

“We have always been quite siloed in the way we treat disease,” says Prof Deanfield. “You have a different specialist for each problem.

“However, the impact of these drugs is helping us see that many diseases are linked by the same issue: chronic inflammation.

“If we have a drug that fights that, then we might have a more joined-up way of treating all diseases.”

Broaden your horizons with award-winning British journalism. Try The Telegraph free for 1 month with unlimited access to our award-winning website, exclusive app, money-saving offers and more.