Más allá de la pérdida de peso: ¿podrían los agonistas del GLP-1 mejorar la salud del corazón?

La salud del corazón

by Javed Butler, MD

junio13,2024

Could a popular weight loss medication help lower your risk of Ataque al corazón or Carrera? You’ve likely heard the buzz around a weight loss drug called semaglutide, a type of GLP-1 agonist used to treat type 2 diabetes and obesity.

But its benefits could extend beyond weight loss—in fact, new research shows semaglutide could lower people’s risk for adverse cardiac events by as much as 20%.

For people who are obese and at high risk of recurrent heart attack or stroke, GLP-1 agonists like semaglutide can be a game-changer. But what are they, how do they work and are they the right choice for you?

Esto es lo que necesita saber.

GLP-1 for weight loss

GLP-1 agonists are effective at causing weight loss because they mimic a hormone in your body called GLP-1 (glucagon-like peptide-1). This helps control blood sugar levels, reduce appetite and improve heart health.

Weight loss medications are nothing new, but what makes GLP-1 agonists different is how they influence appetite and satiety. Other weight loss drugs are designed to increase the number of calories burned, but they don’t address the increase in appetite that many people feel because they’re burning calories. Because of this, many people end up eating more food and therefore don’t lose as much weight or can’t keep the weight off.

GLP-1 agonists like semaglutide are more effective because they do several things:

  • Aumenta la secreción de insulina, el proceso por el cual el páncreas libera más insulina al torrente sanguíneo.
  • Disminuir la secreción de glucagón. El glucagón es una hormona que eleva los niveles de azúcar en sangre. La disminución de la secreción de glucagón ayuda a reducir los niveles de azúcar en sangre.
  • Mejorar la utilización de la glucosa, lo que ayuda al cuerpo a utilizar el azúcar de manera más eficiente para obtener energía.
  • Retrasar el vaciado gástrico y la rapidez con la que los alimentos salen del estómago, lo que hace que te sientas lleno por más tiempo.
  • Disminuye el apetito, reduciendo las ganas de comer más.
  • Aumenta la saciedad, haciéndote sentir lleno por más tiempo.

The biggest difference is those last two points—these drugs work in the area of the brain called the central hypothalamus to decrease appetite and increase satiety. That means you don't feel as hungry and you feel full faster, making it easier to lose weight and maintain that weight loss.

Semaglutide for heart health

These drugs were originally developed for Type 2 Diabetes and weight loss. But new research shows that people who are obese and have cardiovascular disease not only experience weight loss, but also a decrease in their risk of heart attack, stroke and death.

It’s important to understand that semaglutide is marketed under two different names for two different doses. It’s the same drug, but they come in different doses for different uses—one for Type 2 diabetes, and one at a higher dose for weight loss and now for lowering heart disease risk in obese people.

Semaglutide works to lower risk of heart attack, stroke, and death from heart disease by decreasing the adiposity, or accumulation of fat, in your body. Adiposity can be systemic, impacting the health of your entire body. Excess fat that we carry in our belly or thighs can lead to chronic conditions such as:

  • Inflamación
  • Estrés oxidativo (una condición en la que su cuerpo tiene demasiadas moléculas conocidas como radicales libres)
  • Alta presion sanguinea 

La adiposidad también puede localizarse alrededor de un determinado órgano, como el corazón, lo que aumenta el riesgo de sufrir problemas relacionados con los órganos.

Bottom line: the driving factor for heart disease and cardiovascular events is excess fat. For people who are obese, drugs like semaglutide that cause significant fat loss can be lifesaving, reducing the risk of heart attack or stroke and putting people on the path to better well-being.

Should you take GLP-1 agonists?

So, are GLP-1 agonists a good option for you? If you are obese or overweight and at risk for cardiovascular disease, you may want to consider talking to your doctor about medication options like semaglutide.

Nothing in medicine is one-size-fits-all, so it’s important to have a conversation with your doctor about your individual risk factors, lifestyle and health history so you can make the best decision for your future health. Taking this drug does not mean your lifestyle doesn’t matter. It’s still important to eat well, exercise and take care of yourself; these are fundamental to improving your health.

To have the biggest impact on your health, medications should be used in combination with heart-healthy lifestyle changes. The less dependent you are on medication, the better off you’ll be.

Si está buscando mejorar la salud de su corazón, los siguientes son buenos pasos:

  • Consuma una dieta baja en sal.
  • Gestiona tu ingesta calórica.
  • Hacer ejercicio regularmente.
  • No fumes
  • Abordar los factores de riesgo individuales (como la presión arterial alta, la diabetes y el colesterol alto).

Una de las mejores cosas que puedes hacer para perder peso es el ejercicio. Pero cuanto más sobrepeso tienes, más difícil te resulta hacer ejercicio, ¿verdad? Ese es uno de los beneficios de estos medicamentos para bajar de peso: para muchas personas, les ayuda a superar ese obstáculo, de modo que pierden algo de peso y luego pueden hacer ejercicio y vivir un estilo de vida más activo.

The same goes for diet as well. Many people who struggle with obesity feel hungry all the time. Semaglutide may help reduce their appetite, making it easier for them to make healthier food choices and achieve the weight loss needed to improve their heart health.

GLP-1 side effects

There are side effects and risks to keep in mind when starting any new medication. That’s why talking to a physician about your individual concerns and health history is important.

GLP-1 agonists like semaglutide should not be taken by people who have a history or family history of thyroid cancers or endocrine neoplasia, any allergies to the ingredients, or previous allergic reaction or angioedema due to similar drugs.

Potential side effects include:

  • Can cause pancreatitis
  • Puede causar enfermedad de la vesícula biliar.
  • Hipoglucemia (bajo nivel de azúcar en sangre)
  • Problemas digestivos (náuseas, vómitos, diarrea, dolor abdominal)

If you’re worried about side effects, talk to your doctor about how to introduce the medication gradually and slowly increase your dose over time to help lessen any side effects you experience.

The future of weight loss research

We’re continuing to study how these medications can be used to optimize people’s well-being and manage various health risks.

While this is an important step forward in improving quality of life for obese people with heart conditions, we’re now looking to prevention—why couldn’t we use medications like this to prevent heart issues in the first place? But this needs to be tested.

Research is also exploring how these drugs can help manage other heart conditions like heart failure, as well as issues impacting other organs like the kidney and liver. The good news is, lowering excess fat can have powerful effects throughout the body, meaning there are a lot of potential uses for these medications.

If you have questions about whether weight loss drugs like GLP-1 agonists are right for you, talk to your doctor or cardiologist. Or find a doctor near you today.

Sobre el Autor

Javed Butler, MD, es cardiólogo y presidente del Baylor Scott & White Research Institute.

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