Hormonal
Semaglutide and tirzepatide reduce cardiovascular risk and improve cardiac function through pleiotropic mechanisms including endothelial protection, anti-inflammation, and inhibition of cardiomyocyte apoptosis, independent of glycemic control.
If you have obesity and existing heart disease, semaglutide (2.4 mg weekly) significantly lowers your risk of heart attack, stroke, and cardiovascular death, even if you do not have diabetes. This benefit comes from direct protection of your blood vessels and heart muscle, not just weight loss.
Incretins can be classified as disease-modifying therapy drugs, since they affect the cardiovascular system, improving the functional state of the endothelium, reducing blood pressure, slowing platelet aggregation, inhibiting cardiomyocyte apoptosis, improving glucose utilization, and exerting a vasodilating effect. This explains the reduction in the risk of cardiovascular complications observed in clinical studies, and in experimental studies, a decrease in the necrosis zone during modeling of myocardial infarction and the use of incretin mimetics.
Why this rating
The paper cites large-scale randomized clinical trials (SUSTAIN-6, SELECT) with statistically significant primary endpoints (MACE reduction).
Source
Cardiovascular effects of semaglutide and tirzepatide and their potential for cardioprevention
D. V. Cherkashin et al. · Meditsinskiy sovet = Medical Council · 2025
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