Why Are GLP-1 Medications So Popular?
GLP-1 medications such as Ozempic, Wegovy, and Mounjaro have become extremely popular in recent years. They help manage blood sugar and support weight management. A growing body of research also highlights additional health benefits, including improvements in heart health, cholesterol, and blood pressure.
Now, a recent study raises an important question: What happens to heart health after people stop taking GLP-1 medications?
What Did the Study Find?
Researchers from Washington University School of Medicine in St. Louis found that the cardiovascular protection linked to these medicines may diminish after treatment is interrupted. Published in BMJ Medicine, the study followed more than 333,000 US veterans with type 2 diabetes for three years, examining outcomes including heart attack, stroke, and death.
Researchers compared 132,551 people prescribed GLP-1 medications with 201,136 people taking sulfonylureas, another class of diabetes medicines. Treatment status was assessed every six months. Key findings include:
- Continuous treatment showed higher protection: People who remained on GLP-1 therapy throughout the three-year study had an 18% lower risk of major cardiovascular events compared with those taking sulfonylureas.
- Six-month gaps mattered: People who interrupted treatment and later restarted had weaker cardiovascular protection than those who continued without a break.
- One year off treatment: Those who remained off GLP-1 medicines for one year had a 14% higher cardiovascular risk compared with continuous users.
- Two years off treatment: The increase reached 22% after two years without therapy. Major cardiovascular events included heart attack, stroke, and death.
Why Could Stopping GLP-1 Medicines Affect the Heart?
GLP-1 medicines do more than lower blood sugar or help with weight loss. They can influence several factors linked to cardiovascular health, including blood sugar, body weight, blood pressure, and other metabolic processes.
Ziyad Al-Aly, MD, a WashU Medicine clinical epidemiologist and chief of the Research and Development Service at the VA Saint Louis Health Care System, and senior author of the study, said, "Our data suggest this metabolic whiplash is detrimental to heart health. Restarting the medication helped restore some protection, but only partially, showing that discontinuation leaves a lasting scar."
According to the study's senior author, stopping treatment may be followed by a return of some metabolic changes. Weight may increase again, while blood pressure, cholesterol, and inflammation may also worsen. These changes could contribute to cardiovascular risk.
What Happens If Treatment Is Interrupted?
The study suggests that cardiovascular benefits may not remain unchanged when treatment is interrupted. People who temporarily stopped their medication and later restarted it had an average 12% reduction in cardiovascular risk, compared with an 18% reduction among those who continued treatment throughout the study.
Even a six-month treatment gap was associated with a 4% to 8% increase in cardiovascular risk compared with uninterrupted use. This suggests that following treatment may matter when GLP-1 medication has been prescribed for a chronic condition.
Why Do People Stop GLP-1 Medications?
Stopping treatment is common. In this study, 26% of GLP-1 users discontinued the medication, while about 23% experienced a treatment gap of at least six months before restarting. There can be several reasons for stopping, including:
- Side effects: Nausea, vomiting, diarrhoea, and other digestive symptoms can make the treatment difficult for some people.
- Cost: Long-term treatment can be expensive, particularly when insurance or reimbursement does not cover the medication.
- Medicine shortages: Supply problems can make it difficult for patients to maintain regular treatment.
- Weight-loss expectations: Some people may stop once they reach a desired weight, without understanding that treatment may need to continue to maintain its effects.
- Treatment changes: Doctors may change or discontinue medication when a patient's medical needs change.
How to Better Manage Cardiovascular Health
For patients using or considering stopping GLP-1 medications, it is important to communicate fully with a doctor and avoid stopping on your own. Regular monitoring of blood sugar, blood pressure, weight, and cholesterol can help detect changes early.
The Xiaoshu Health App can sync with Apple Health to track relevant metrics, helping you continuously record blood sugar, weight, blood pressure, and other data for reference during medical visits.
Disclaimer: This content provides generic information only and is not a substitute for qualified medical advice. Always consult a specialist or your own doctor for more information.