Walter G. Wasser

Semaglutide: A New Hope for Heart Health

The world of medicine is continually evolving, bringing new hope and treatments for chronic conditions. One such breakthrough is the SELECT trial, which has revealed significant benefits of the medication semaglutide for individuals with obesity, particularly those with heart disease but without diabetes. This blog post aims to explain what the SELECT trial discovered and what these findings mean for you if you are living with obesity and related health concerns.

What is Semaglutide?

Semaglutide is a medication that has shown promise in managing obesity and reducing cardiovascular risks. It belongs to a class of drugs known as GLP-1 receptor agonists (GLP-1RAs). Originally, semaglutide was used to treat type 2 diabetes by mimicking the incretin hormones in your body that help regulate blood sugar levels. Over time, researchers discovered that semaglutide also has significant benefits for weight loss and heart health.

Key Findings from the SELECT Trial

The SELECT trial focused on evaluating semaglutide in individuals who have obesity and pre-existing atherosclerotic cardiovascular disease but do not have diabetes. This was a groundbreaking study because it was the first time a GLP-1RA was tested specifically in this population. Here are the primary outcomes of the trial:

  1. Reduced Major Cardiovascular Events: The trial found that semaglutide led to a 20% reduction in major cardiovascular events, such as heart attacks and strokes. This is a substantial finding, as it demonstrates that semaglutide can significantly improve heart health in people with obesity.
  2. FDA Approval: As a result of these positive outcomes, the U.S. Food and Drug Administration (FDA) approved semaglutide for reducing cardiovascular risk in adults with obesity. This makes it the first medication for obesity to receive such an indication in the United States.

Long-term Benefits of Semaglutide

The benefits of semaglutide extend beyond just reducing heart risks. Here are some of the long-term advantages of this medication:

  1. Sustained Weight Loss: One of the most notable benefits of semaglutide is its ability to promote and maintain weight loss. The SELECT trial showed that semaglutide helps achieve durable weight loss across various demographic groups, including different ages, sexes, races, and body mass index (BMI) categories. This sustained weight loss is crucial because it can lead to improvements in numerous obesity-related conditions.
  2. Improved Kidney Health: Another significant finding from the SELECT trial is that semaglutide may help slow the decline in kidney function and reduce albuminuria (a marker of kidney damage). This suggests that semaglutide could offer protective benefits for kidney health, which is particularly important for those at risk of chronic kidney disease (CKD).

Understanding the Impact of Semaglutide

The results of the SELECT trial have important implications for individuals with obesity and related health conditions. Here’s what you need to know about how semaglutide can impact your health:

  1. Heart Health: Semaglutide’s ability to reduce major cardiovascular events means that it can be a valuable tool in managing heart disease. If you have obesity and heart disease, semaglutide can help lower your risk of heart attacks and strokes.
  2. Weight Management: Sustained weight loss is one of the key benefits of semaglutide. Losing weight can improve your overall health and reduce the risk of developing other chronic conditions, such as type 2 diabetes and heart failure.
  3. Kidney Protection: The potential kidney-protective effects of semaglutide are promising, especially for those at risk of CKD. By slowing the decline in kidney function, semaglutide can help maintain kidney health over the long term.

Further Research Needed

While the results of the SELECT trial are promising, further research is necessary to fully understand the benefits of high-dose semaglutide, particularly for kidney health. Further trials of high-dose semaglutide in individuals with CKD and obesity but without diabetes are now required to prove a definitive protective action against CKD. Such trials could also show whether such CKD benefits are additive to those from SGLT2 inhibitor treatment. These trials are crucial to establish the full extent of semaglutide’s protective effects on kidney function.

What This Means for You

If you are living with obesity and related health conditions, the findings from the SELECT trial offer new hope. Semaglutide could be a valuable part of your treatment plan, providing benefits beyond weight loss. It’s important to discuss with your healthcare provider whether semaglutide is right for you. They can help you understand the potential benefits and any side effects, which may include gastrointestinal discomfort.

Discussing Semaglutide with Your Doctor

Before starting any new medication, it’s essential to have a thorough discussion with your healthcare provider. Here are some questions to consider asking:

  • Is semaglutide suitable for my specific health condition?
  • What are the potential benefits and risks of taking semaglutide?
  • How is semaglutide administered, and what should I expect?
  • Are there any lifestyle changes I should make while taking semaglutide?
  • How will we monitor the effectiveness of the medication?

Looking Ahead: The Future of Anti-Obesity Medications

As more evidence accumulates about the benefits of anti-obesity medications like semaglutide, it is likely that these drugs will become more widely prescribed and accessible. The hope is that increased market competition will drive down costs, making these treatments available to more people who could benefit from them.

In the future, we can expect to see more medications that offer similar benefits, giving healthcare providers a broader range of treatment options. This is crucial because the number of people living with obesity and related comorbidities is substantial, and effective treatments can make a significant difference in their quality of life.


The SELECT trial has highlighted the potential of semaglutide as a groundbreaking treatment for individuals with obesity and cardiovascular disease. Its ability to reduce major cardiovascular events, promote sustained weight loss, and offer potential kidney protection makes it a valuable addition to the arsenal of treatments available for managing obesity and its related health concerns.

If you are considering new treatments for obesity-related health issues, semaglutide might be worth discussing with your healthcare team. As we continue to find more ways to tackle obesity and improve heart health simultaneously, medications like semaglutide represent a significant step forward in the fight against chronic diseases.

Remember, managing your health is a journey, and staying informed about the latest medical advancements can empower you to make the best decisions for your well-being. Physicians can now add these treatments to their therapeutic armamentarium.

Reference:Colhoun, H. M., Lingvay, I., Brown, P. M., Deanfield, J., Brown-Frandsen, K., Kahn, S. E., Plutzky, J., Node, K., Parkhomenko, A., Rydén, L., Wilding, J. P. H., Mann, J. F. E., Tuttle, K. R., Idorn, T., Rathor, N., & Lincoff, A. M. (2024). Long-term kidney outcomes of semaglutide in obesity and cardiovascular disease in the SELECT trial. Nature Medicine. Published: 25 May 2024.

About the Author
The author is a specialist in nephrology and internal medicine and lives with his wife and family in Jerusalem.