GLP-1s & the Heart

Same drug class, two opposite heart stories.

Semaglutide, 17,000 people with obesity and heart disease, heart attacks, strokes, and cardiac deaths down 20%.

Liraglutide, 241 people with weak hearts, heart rate up seven beats a minute, serious cardiac events tripled.

Both are real.

Today you get the full ledger than my verdict.

Welcome to Straight Shot.

I'm Dr. Clete Baric, founder at Baric Health and board certified in internal medicine and obesity medicine.

Season two is one organ per episode, benefits, harms, and where I land.

Last time was liver, today it's the heart.

This is the easiest verdict of the season, and I'll tell you why.

The heart is the one organ where we don't have to argue from lab values or scans.

We have outcome trials.

Heart attack, strokes, hospitalizations, deaths actually counted in roughly 100,000 randomized people.

No other organ in the GLP-1 world comes close to that data as of now.

Let's start with scope.

Today is the heart and the events that come off of it.

So heart attack, stroke, cardiovascular death, heart failure, rhythm problems, heart rate, blood pressure.

Stroke stays in this episode because every heart trial counts it.

The kidney gets its own episode, and that one's next, and so do the blood vessels.

The timing here is wild.

On August 28th, one week ago, as I record this, the FDA put a heart attack and stroke indication on Manjaro.

Same day, the European Society of Cardiology wrote semaglutide and terzepatide into its heart failure guideline, both in one afternoon.

Busy day.

So yeah, verdict up front, and I'll earn it as we go through all of this.

Net positive for the heart and I am at high certainty with two asterisks in this one.

The weak pump kind of heart failure and the heart rate bump.

And one, not yet.

That's red a true tide.

And anyone who doesn't already have heart disease as well.

So we'll start with the benefit column first, then the harm column, and then what I actually tell my patients.

Same drug class, two opposite heart stories.

Semaglutide, 17,000 people with obesity and heart disease, heart attacks, strokes, and cardiac deaths down 20%.

Liraglutide, 241 people with weak hearts, heart rate up seven beats a minute, serious cardiac events tripled.

Both are real.

Today you get the full ledger than my verdict.

Welcome to Straight Shot.

I'm Dr. Clete Baric, founder at Baric Health and board certified in internal medicine and obesity medicine.

Season two is one organ per episode, benefits, harms, and where I land.

Last time was liver, today it's the heart.

This is the easiest verdict of the season, and I'll tell you why.

The heart is the one organ where we don't have to argue from lab values or scans.

We have outcome trials.

Heart attack, strokes, hospitalizations, deaths actually counted in roughly 100,000 randomized people.

No other organ in the GLP-1 world comes close to that data as of now.

Let's start with scope.

Today is the heart and the events that come off of it.

So heart attack, stroke, cardiovascular death, heart failure, rhythm problems, heart rate, blood pressure.

Stroke stays in this episode because every heart trial counts it.

The kidney gets its own episode, and that one's next, and so do the blood vessels.

The timing here is wild.

On August 28th, one week ago, as I record this, the FDA put a heart attack and stroke indication on Manjaro.

Same day, the European Society of Cardiology wrote semaglutide and terzepatide into its heart failure guideline, both in one afternoon.

Busy day.

So yeah, verdict up front, and I'll earn it as we go through all of this.

Net positive for the heart and I am at high certainty with two asterisks in this one.

The weak pump kind of heart failure and the heart rate bump.

And one, not yet.

That's red a true tide.

And anyone who doesn't already have heart disease as well.

So we'll start with the benefit column first, then the harm column, and then what I actually tell my patients.