Ozempic for heart disease? Doctors think it’s worth considering
The Heart Foundation says Australia can no longer overlook the role of obesity in cardiovascular disease and wants to form a national taskforce to improve patient outcomes and consider if GLP-1 drugs could help.
A new taskforce will be established to improve the way obesity and cardiovascular disease are managed together in Australia, and to consider if more GLP-1 medications should be used to treat heart conditions.
The Heart Foundation is calling on clinical experts and peak bodies to unite to develop an industry-wide consensus statement and guidance to improve patient outcomes.
“Obesity is a leading driver of cardiovascular disease, yet its role in cardiovascular
health is often overlooked,” said Professor Garry Jennings, the Heart Foundation’s chief medical adviser.
“We are lucky to have a number of new treatment options available, and many more on the horizon, to not only support weight loss but also improve cardiovascular outcomes in people that need it most.
“Change won’t just be achieved with pharmaceuticals. It won’t just be achieved with prevention messages. It won’t just be achieved with support programs. But we do need to have a better strategy than we’ve had so far,”
Data from the Australian Institute of Health and Welfare shows the proportion of Australians who are overweight or obese is above the OECD average, and is linked to 30 diseases including cardiovascular disease, cancers and Type 2 diabetes.
Although a lot of treatment strategies in Australia have concentrated on lifestyle factors, there’s now an understanding that not enough consideration has also been given to other contributors including genetics that can increase a person’s risk of developing obesity and, in turn, cardiovascular disease.
That’s where some pharmaceuticals, such as GLP-1 medications, could come into play, especially as new evidence emerges suggesting potential cardiovascular benefits for some people. However, more studies will be needed.
The best-known GLP-1 medication is Ozempic, though in Australia it is only approved for the management of Type 2 diabetes in cases that cannot be managed by medications, diet and exercise alone.
“There are trials in people that weren’t diabetic but have heart disease showing benefits (of GLP-1),” Professor Jennings said.
“So, we think there’s no question that they will have a role in future guidelines in management of some common cardiovascular conditions including after heart attacks, perhaps people with heart failure and other conditions. So whether there’s a broader scope for it in prevention in other areas is something that we want to examine.”
Ozempic and the drug Wegovy are both GLP-1 agonists and contain the same active ingredient, semaglutide, but the approved uses remain different, as do the dosages.
Last year, the US federal drug regulator, the FDA, approved a new indication for the use of Wegovy to reduce the risk of cardiovascular death, heart attack and stroke in adults with cardiovascular disease and obesity or who are overweight.
In December, Australian reglators approved Wegovy for risk reduction of major adverse cardiovascular events. But the Heart Foundation worries there is still some clinical resisitance to using the drugs for cardiovascular purposes.
However, all of this is worth considering against a backdrop of significant supply shortages of some GLP-1 medications because of their on and off label results for weight loss.
Wegovy is specifically targeted towards weight loss and was approved for use in Australia from August 2024.
The latest advice from Ozempic’s manufacturer is that stock to Australia will remain low for the whole of this year. Nonetheless, it is still something doctors say is worth considering as governments try to negotiate greater access to the medications.
“Two-thirds of Australians are defined as overweight and obese and that’s putting them at significant risk of cardiovascular heart stroke and vascular disease,” Professor Jennings said.
The Heart Foundation wants to co-ordinate the formation of the new taskforce, which it anticipates will include national experts, host joint stakeholder meetings to discuss key clinical and policy considerations and publish evidence based guidance for health professionals.
Professor Jennings also expects the group to work to address issues of stigma associated with weight and cardiovascular conditions, consider ways to improve at-risk groups including First Nations people, and look at more preventive measures that could be taken.
“Without pre-empting what might come out of this, there might be a case for stronger action as far as availability of junk foods for kids, for example. I wouldn’t want it to be just about GLP-1 inhibitors. On the other hand, they are such an important new tool,” he said.
“We’ve got to make sure we address the stigma, which is not only distressing to people, but also a barrier to better management. And we’ve got to make sure that we don’t impact people with eating disorders.
“We really think it’s important to have all the players around the table at once and come out with some common views.”
It is hoped the taskforce will come together in June or July.
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