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GLP-1 Medications and Heart Health in Australia: Do They Cut Cardiovascular Risk Beyond Weight Loss?

Summary:

Large, high-quality trials now show semaglutide (a GLP-1 medicine) reduces major cardiovascular events (heart attack, stroke, cardiovascular death) in people with overweight/obesity who already have cardiovascular disease—even without diabetes. The SELECT trial reported about a 20% relative risk reduction in MACE, with consistent benefits across subgroups, and follow-on analyses suggest improvements in heart-failure-related outcomes and symptoms. In Australia, Wegovy (semaglutide 2.4 mg) is TGA-approved for reducing cardiovascular risk in eligible adults, though PBS subsidy currently does not cover obesity or CVD-risk indications, so out-of-pocket costs apply. Lifestyle still matters: medication works best when paired with nutrition, activity, sleep, and risk-factor optimisation. New England Journal of Medicine American College of Cardiology RACGP


What’s new + why it matters:

The SELECT trial found semaglutide 2.4 mg cut major cardiovascular events by ~20% in adults with overweight/obesity and established CVD—without diabetes. That’s a first of its kind and widens who may benefit beyond glucose control. New England Journal of Medicine American College of Cardiology


The truth behind GLP-1 Medications and Heart Health in Australia
The truth behind GLP-1 Medications and Heart Health in Australia

Who is this for?

Consider a cardiometabolic consult if you (or a loved one) have:

  • Established cardiovascular disease (e.g., previous heart attack, stroke, PAD) and BMI ≥27 kg/m², without diabetes—the SELECT population. American College of Cardiology

  • Heart failure with preserved EF (HFpEF) plus overweight/obesity—semaglutide improved symptoms/fitness in trials. New England Journal of MedicineThe Lancet

  • Multiple risk factors (hypertension, high LDL, sleep apnoea, fatty liver) where additional risk-lowering is desired. (Clinical judgment required.)

  • Past attempts at lifestyle change with limited sustained effect and interest in evidence-based medical options to reduce future events.

What the latest research shows for GLP-1

  • SELECT (NEJM 2023): In 17,604 adults with overweight/obesity + established CVD but no diabetes, once-weekly semaglutide 2.4 mg reduced MACE vs placebo (HR 0.80; 95% CI 0.72–0.90). Benefits were consistent across most subgroups. New England Journal of MedicineAmerican College of CardiologyWiki Journal Club

  • Heart failure signal: Pooled data and SELECT sub-analyses indicate fewer HF events and benefit regardless of HF subtype; separate STEP-HFpEF trials showed improved symptoms, weight and exercise capacity with semaglutide. The Lancet+1New England Journal of Medicine

  • Mechanisms likely multi-factorial: Weight loss, reduced inflammation and improved metabolic profile may contribute; mediation analyses suggest benefit not solely explained by weight loss. Atherosclerosis JournalAcademic Oxford

  • Real-world & conference updates (2025): Ongoing observational and HFpEF data presented at ESC 2025 continue to support cardiometabolic benefits of GLP-1 agents. (Observational data complement but do not replace RCT evidence.) ReutersClinical Trials Arena

Safety snapshot (what we watch for):Most common: GI symptoms (nausea, vomiting), gallbladder disease, rare pancreatitis; retinopathy risk mainly pertains to rapid glucose lowering in diabetes (less relevant in SELECT’s non-diabetic cohort). See Australian Product Info for full details and contraindications. Therapeutic Goods Administration (TGA)

Book a preventive consult—Longevity & Prevention Program

What to do next (your step-by-step)

  1. Risk review (telehealth): Bring recent lipids, HbA1c, eGFR, liver tests, blood pressure readings, meds list, and CVD history. We’ll confirm eligibility vs. SELECT-like criteria and discuss options.

  2. Lifestyle foundation (non-negotiables): Mediterranean-style nutrition, 150–300 min/week moderate activity (or personalised plan), sleep optimisation, and smoking/alcohol risk reduction—medication works with, not instead of, lifestyle.

  3. Shared decision-making: Discuss benefits (MACE reduction), side effects, interactions, and monitoring: weight, BP, labs (renal, LFTs), and symptom tracking.

  4. Prescription & titration: If appropriate, we’ll prescribe semaglutide and titrate to 2.4 mg weekly (Wegovy) as tolerated, with scheduled follow-ups. Therapeutic Goods Administration (TGA)

  5. Integrated care: We may arrange cardiac imaging (e.g., calcium score/CTCA where indicated), sleep study if symptoms suggest OSA, and dietitian/exercise physiology referrals to compound cardiometabolic benefit.

Book a preventive consult—Same day available
The growing options of GLP-1 medication - the team at Zelica can help you choose the most suitable for you
The growing options of GLP-1 medication - the team at Zelica can help you choose the most suitable for you

Costs & access in Australia

  • Regulatory status: Wegovy is TGA-approved for reducing MACE in adults with established CVD and BMI ≥27 kg/m², without diabetes. RACGP

  • PBS status: As of September 2025, GLP-1s are not PBS-subsidised for weight loss or for CVD-risk reduction; Ozempic remains PBS-subsidised only for type 2 diabetes that meets criteria. The GuardianPharmaceutical Benefits Scheme

  • Private costs (guide): Public reporting suggests Wegovy ~A$460 per 2.4 mg dose; tirzepatide initiation often ~A$395/month privately. Prices vary by pharmacy and dose. RACGP

  • Supply: Ozempic supply has stabilised in 2025 per manufacturer and Diabetes Australia updates; Wegovy availability may vary by pharmacy. Check locally. Novo NordiskDiabetes Australia

  • Clinic fees: Zelica Health uses a mixed billing model; Medicare rebates may apply to eligible consults. We’ll outline fees before your appointment.

Book a preventive consult—Longevity & Prevention Program

FAQ

1) I don’t have diabetes. Could a GLP-1 still help my heart?

Yes—SELECT specifically enrolled people without diabetes and showed a ~20% reduction in MACE with semaglutide 2.4 mg vs placebo. New England Journal of Medicine


2) Will I need this long-term?

Cardiovascular risk reduction is generally chronic; many patients remain on therapy long-term if benefits/side-effects are favourable, with periodic reviews—similar to statins or antihypertensives.


3) What side effects should I expect?

Mostly GI (nausea, reflux, vomiting), especially during dose escalation; we titrate slowly and give anti-nausea/lifestyle tips. Rare risks include gallbladder disease and pancreatitis; we review your history and monitoring plan. Therapeutic Goods Administration (TGA)


4) Does weight loss explain all the benefit?

No—analyses suggest risk reduction exceeds weight-loss alone, implying anti-inflammatory/metabolic effects too. Atherosclerosis JournalAcademic Oxford


5) Can it help if I have HFpEF?

Trials in HFpEF with obesity show improved symptoms and function; event-reduction data are emerging. Suitability is individual—let’s review your profile. New England Journal of MedicineThe Lancet



Curious if GLP-1s are appropriate for you? Book a cardiometabolic consult.



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References

  1. Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes (SELECT). N Engl J Med. 2023. New England Journal of Medicine

  2. SELECT Trial Summary. American College of Cardiology. American College of Cardiology

  3. Semaglutide in HFpEF. N Engl J Med. 2023. New England Journal of Medicine

  4. Semaglutide & HF outcomes in CVD with obesity (sub-analyses). The Lancet. 2024. The Lancet

  5. Australian Product Assessment/PI – Wegovy. TGA AusPAR (Sept 2024). Therapeutic Goods Administration (TGA)

  6. TGA approval: Wegovy for reduction of MACE in adults with established CVD, BMI ≥27 kg/m², without diabetes (indication extension). RACGP (Feb 2025 update). RACGP

  7. PBS status & pricing context (GLP-1 not PBS-listed for obesity; Wegovy cost examples; tirzepatide private pricing). RACGP (2025). RACGP

  8. Ozempic supply update: Manufacturer notice (July 2025) and Diabetes Australia (Aug 2025). Novo NordiskDiabetes Australia

  9. Atherosclerosis/ESC abstracts: Inflammation and mediation analyses from SELECT; ESC 2025 cardiometabolic updates. Atherosclerosis JournalAcademic OxfordClinical Trials Arena

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