GLP-1 drugs cut heart attacks and strokes without much of a foothold in the heart

Cardiovascular outcome trials in people with type 2 diabetes showed that GLP-1 receptor agonists reduce the rates of non-fatal heart attack, non-fatal stroke and cardiovascular death. How they manage it turns out to be stranger than the result.

Mechanism is the puzzle. One canonical GLP-1 receptor sits in the heart and blood vessels at low levels, too sparse to carry the whole effect, while the same drugs reduce body weight, glucose, blood pressure and inflammation. Protection arriving by that route is indirect by definition, and a direct cardiac action is not ruled out, only hard to isolate in a living person.

Worth knowing who did the reading. The senior author consults for drugmakers with programmes in this field and his hospital has taken funding from two of them for preclinical work, ordinary in a small discipline and still a frame. Nothing was measured here; the paper gathers trials other groups ran.

Phase III outcome trials are running in two groups the first round never covered, people with heart failure with preserved ejection fraction and people living with obesity. Whether the newer multi agonists, substantially better at reducing body weight, also move cardiac events is unanswered, and any of it belongs with a qualified clinician who knows a person's health history.

Read the full story at Nature ↗

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