Healthy Executive

Semaglutide, the renowned drug known for its effectiveness in diabetes management and weight loss, is now showing promise beyond these realms. Recent research has unveiled its potential to transform the lives of individuals grappling with heart problems and obesity.

In a groundbreaking global trial involving over 500 participants from 13 countries, semaglutide, administered as a weekly injection over a year, led to significant improvements in symptoms of heart failure such as fatigue, shortness of breath, and swelling. Additionally, participants experienced remarkable enhancements in physical abilities and exercise performance. These astonishing findings were published in the New England Journal of Medicine in late August.

Cardiovascular failure, a condition characterized by the heart's inability to pump sufficient blood to meet the body's needs, is a growing health concern. Renowned cardiologist Mikhail Kosiborod states that obesity may be the primary cause of cardiovascular failure in these patients. This prompted researchers to investigate if semaglutide, by targeting weight, could alleviate symptoms. The results were nothing short of astounding.

Using a widely used 100-point scale to assess heart failure symptoms and quality of life, participants taking semaglutide saw nearly a 17-point improvement, in stark contrast to the modest 9-point increase in the placebo group. Semaglutide recipients achieved an average weight loss of 13.3% compared to a meager 2.6% reduction in the placebo group. They also demonstrated a 20-meter increase in their walking distance during a six-minute endurance test and experienced fewer hospitalizations and emergency visits over the one-year study period.

The relationship between obesity and cardiovascular failure is complex. Excessive weight gain can trigger inflammation, including in the heart, leading to increased stiffness and a higher risk of cardiovascular failure. Moreover, greater body weight elevates blood volume, increasing pressure inside the heart and causing congestion. Hypertension can further thicken the heart muscle, hindering its ability to pump blood.

While weight loss may explain some of semaglutide's benefits in cardiovascular failure patients, Kosiborod suggests that the drug likely operates through other mechanisms that researchers have yet to fully unravel.

Remarkably, Novo Nordisk, the manufacturer of Ozempic and Wegovy, is conducting further research to explore if semaglutide offers wider cardiovascular benefits. In a recent announcement, the company revealed that weekly semaglutide injections over five years reduced the risk of stroke and heart attack by 20% among over 17,000 people with obesity and a history of cardiovascular disease. Detailed results are expected to be unveiled at an upcoming conference, sparking excitement among experts.

Martha Gulati, head of preventive cardiology at Cedars-Sinai Medical Center, Los Angeles, finds these reductions in cardiovascular events intriguing, pointing to an underlying mechanism yet to be fully understood. Gulati hypothesizes that semaglutide could possess anti-inflammatory properties among other undisclosed effects. Furthermore, there is early evidence suggesting that Ozempic and Wegovy may curb alcohol cravings. A Swedish study published in June demonstrated that administering the drug to alcohol-dependent rodents resulted in a 50% reduction in alcohol consumption.

Nathan Wong, head of the Heart Disease Prevention Program at the University of California, Irvine School of Medicine, highlights the significance of semaglutide considering the recent cardiovascular failure findings and Novo's exciting announcement. These discoveries build upon previous research from 2021, which showcased semaglutide's potential to reduce body weight and improve cardiovascular risk factors.

Wong and his colleagues used statistical modeling to evaluate the substantial impact semaglutide could have on the U.S. population. Their study, published in August, projected that if all 93 million overweight and obese adults in the US were prescribed semaglutide, it could lead to a staggering 43 million fewer individuals with obesity and prevent up to 1.5 million heart attacks, strokes, and other adverse cardiovascular events over a decade.

Currently, statins dominate the landscape of cardiovascular risk reduction medications. However, semaglutide's broader heart benefits could redefine the field. To achieve this, Wong emphasizes the need for improved accessibility. Ozempic's list price stands at $935, while Wegovy's monthly prescription costs $1,350 in the US. Expanding access to these drugs, particularly for the uninsured, remains a critical challenge.

Novo Nordisk is preparing to seek regulatory approval in the US and Europe for additional uses of semaglutide. Once a drug is established in the market, the approval process for new indications typically proceeds swiftly due to established safety profiles. With regulatory approval, this blockbuster drug may pave the way for its own continuation, transforming the landscape of heart health and weight management.

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