The utilisation of anti-obesity medications (AOMs) among people with obesity could potentially alleviate the high prevalence of cardiovascular disease (CVD), according to researchers from Columbia Data Analytics, New York, NY, who reported an 8% relative risk reduction in any CVD events in patients with obesity who took AOMs, was compared to patients with obesity without AOMs.
The researchers explained that recent clinical data indicates that AOMs can positively impact CVD events in individuals with overweight and obesity. Nevertheless, there is limited evidence on using real-world data to explore the association between AOMs and their association with CVD. Therefore, they conducted a retrospective cohort study to analyse the impact of semaglutide and tirzepatide on CVD.
They included 5,926 patients who used AOMs and compared 79,118 patients who did not take AOMs. Average patient age in the AOM cohort was lower than in the non-AOM cohort (71.53 vs. 73.67 years, p<0.0001). In both groups, the majority of patients were female (64.07% vs. 61.15%, p<0.0001).
All baseline CVD-related comorbidities were higher in the AOM group, including the three most prevalent in both cohorts: hypertension (72.44% vs. 61.07%, p<0.0001), type 2 diabetes (64.83% vs. 25.44%, p<0.0001) and hyperlipidaemia (39.08% vs. 30.42%, p<0.0001), followed by smoking history (7.42% vs. 6.31%, p=0.0007), chronic obstructive pulmonary disease (COPD) (6.83% vs. 6.19%, p=0.0468), and chronic kidney disease (3.29% vs. 2.26%, p<0.0001). The prevalence of alcohol use disorder was not statistically significantly different between the two cohorts.
The unadjusted analysis showed that the proportion of any CVD outcomes was significantly lower in the AOM cohort versus the non-AOM cohort (19.36% vs. 21.16%, p=0.0010). In addition, heart failure (4.89% vs. 6.13%, p=0.0001), atrial fibrillation (3.83% vs. 5.17%, p<0.0001), arrhythmia (3.49% vs. 4.14%, p=0.0153) and peripheral vascular disease (2.94% vs. 3.44%, p=0.0395), was significantly lower in the AOM cohort versus the non-AOM cohort. Only ischaemic heart disease was higher in the AOM cohort (0.34% vs. 0.20%, p=0.0289). Coronary artery disease and stroke were not significantly different between the two cohorts.
AOM usage among patients with obesity was associated with an 8% reduction in the risk of CVD compared with those who did not use AOMs (p=0.0068). Patients in the 71 to 80 years age group (p<0.0001) had a 33% reduced risk of CVD compared to the 65 to 70 years patient age group. However, patients in the 80+ age group (p<0.0001) had a 2.01 times greater risk vs. patients in the 65 to 70 years age group. Females had a 26% reduced risk of CVD compared with males (p<0.0001).
The analysis shows that AOM treatment had a protective effect on CVD over approximately the first 375 days. After that, the treatment did not significantly affect the CVD outcomes.
“The 8% relative risk reduction and lower prevalence of CVD outcomes demonstrated in this study indicate that AOM treatment could be an effective solution for alleviating the high prevalence of CVD. AOMs had a significant risk reduction in prevalent cardiovascular conditions such as heart failure and atrial fibrillation,” they concluded. “Our study adds to the literature of how AOMs are revolutionising health care and can be a substantial solution for a prevalent disease like obesity, which is a significant risk factor for many debilitating conditions with high morbidity and mortality.”
The researchers added that future research should investigate whether the CVD risk reduction is attributable solely to weight loss (based on off-label use, as focused on in the present study) or to improved glucose control, alone or in combination with weight loss. In addition, studies should assess how payment type (i.e., self-pay vs. covered benefit) can impact the access to these medications and consequently CVD outcomes of the population of patients with obesity.
The findings were reported in the paper, ‘The association between weight loss medications and cardiovascular complications’, published in Obesity. To access this paper, please click here