December 16, 2025
The FDA has approved Wegovy, the injectable weight-loss medication, to reduce the risk of heart attack and stroke for patients with cardiovascular disease. Wegovy contains semaglutide, a glucagon-like peptide 1 (GLP-1) receptor agonist.
We saw the reduction in the risk of heart attack or stroke before patients even started to lose weight." Cathleen Beaver, MD
Obesity medicine specialist
In general, Wegovy is approved for patients with a BMI of 30 or greater or those with a BMI of 27 or greater who have a comorbidity associated with their excess weight, such as cardiovascular disease. Now, it is also approved for patients who have had a heart attack or stroke, regardless of their BMI.
“In the SELECT trial, patients who previously had a heart attack or stroke had a reduced risk of another cardiac event (heart attack or stroke) before significant weight loss occurred,” says Cathleen Beaver, MD, an obesity medicine specialist at the health system. “The decreased risk of heart attack or stroke preceded significant weight loss and was observed within 3 months of starting Wegovy. So patients with a history of cardiovascular disease and a normal BMI don't necessarily need to be pushed to the higher doses that result in more weight loss, as we often do to treat patients with obesity.”
Additionally, Ryan Ferrell, MD, a cardiologist at the health system, says the weight-loss benefits of Wegovy are also beneficial for the heart and cardio-metabolic risk, for those people who are carrying extra weight.
They (the SELECT trial) found patients who had a history of a heart attack or stroke had a decreased risk of having a second heart attack or stroke on this medication by about 20%." Cathleen Beaver, MD
Obesity medicine specialist
“By helping improve a person's weight, what that's going to do is lead to fewer risk factors like high blood pressure, hypertension and obstructive sleep apnea. Also, obesity is an independent risk factor for all-cause mortality. So anything that can target obesity is going to be good for us,” says Dr. Ferrell.
How effective is the medication for heart disease patients? Dr. Beaver says the results have been remarkable.
“They (the SELECT trial) found patients who had a history of a heart attack or stroke had a decreased risk of having a second heart attack or stroke on this medication by about 20%. And then the other studies of heart disease, in particular, show improvement in heart failure symptoms. It seems like that might be another really great place that we will be looking to use these medications,” says Dr. Beaver.
Given these successful outcomes, Dr. Ferrell says the health system cardiologists have developed systems for getting patients access to the GLP-1 medication faster.
“We kind of have a fast track. We have a clinical pharmacist in our clinics that we can refer to,” says Dr. Ferrell. He explained the clinical pharmacist can help patients manage affordability and cost, oversee titration of the medication and then continue to monitor potential side effects and how well the patient tolerates their dose.
As with any medication, there can be some downsides. Dr. Beaver mentioned that some patients on medications for high blood pressure may experience lower blood pressure once they start losing weight, and may need to have blood pressure medications adjusted. Ultimately this signifies improvement in hypertension, but we want to avoid the symptoms associated with low blood pressure as a patient's hypertension improves," says Dr. Beaver.
For all patients, Dr. Beaver recommends building up physical activity and eating enough protein while taking a GLP-1.
“I would not encourage anyone, especially someone with heart disease, to go out and immediately jump on the rower for 30 minutes. I want them to start slowly and go cautiously to build up their physical activity,” says Dr. Beaver. “If that means a 10-minute walk once a day or twice a day, I'm all for it. That is 10 minutes of walking that they did more today than they did yesterday.”
For protein intake, Dr. Beaver recommends 0.8 to 1 gram of protein per kilogram of body weight to maintain weight and increasing that up to 1.2 to 1.5 grams per kilogram when losing weight. This extra protein may help maintain more muscle mass and bone mass while a patient experiences weight loss.
“I really try to simplify it for patients: Get protein with every meal and every snack,” says Dr. Beaver. “A chicken breast, about the size of your hand, is 35 grams of protein. So if they can eat 30 to 40 grams of protein every meal, and then get at least 15 or 20 in every snack, they're easily hitting that 100 gram mark.”
She also recommends getting fiber sources – fruits, vegetables and whole grains – with every meal.
“Those are also important components of a nutritious, balanced diet,” she says.