Taking a GLP-1? It May Also Be Helping Your Heart

Lower Afib Risk Regardless of Weight

Researchers at UVA Health analyzed data from 12,812 patients treated with GLP-1s between 2020 and 2023. They compared them with a matched control group of 12,812 patients who didn't receive these medications. They found that patients taking GLP-1 medications had a significantly lower risk of developing Afib as well as lower overall deaths in the group.

One of the most surprising findings was that the lowering in Afib risk remained even among patients who gained weight while taking GLP-1 medications. Kenneth Bilchick, MD, a UVA Health heart rhythm specialist who co-led the study along with Tiago Palmisano, MD, and David Guarraia, MD, explained, “The survival curves in all three groups indicated that there was a reduction in the risk of incident atrial fibrillation regardless of whether you gained weight, lost a little weight, or lost a lot of weight.”

Among the medicines studied, semaglutide showed the strongest association with reduced Afib risk. The researchers noted that semaglutide was also the most commonly prescribed GLP-1 medication during the study period, which may have provided greater statistical power to detect differences among medications.

How Do GLP-1s Affect Heart Health?

If weight loss alone doesn't explain the benefit, inflammation may play an important role.

A layer of fatty tissue surrounds the heart, and when this tissue becomes inflamed, it can contribute to abnormal heart rhythms such as Afib.

Bilchick believes GLP-1 medications may help reduce inflammation in this tissue. “We believe that one of the important mechanisms underlying this effect is likely reduction of inflammation in the fatty tissue around the heart, which we know is an important driver of arrhythmias and other unwanted cardiac outcomes.”

Bilchick plans to continue investigating these inflammatory mechanisms in collaboration with UVA immunology researcher Coleen McNamara, UVA MRI physicist Frederick Epstein (who developed an MRI method to characterize fatty tissue surrounding the heart), and UVA Director of Cardiac Imaging Amit Patel.

The study also raised several additional questions and observations:

• It's not clear how long patients may need to take GLP-1 medications to get the full benefit for Afib risk reduction
• The study suggested that the reduction in Afib risk was most apparent after about 2 years of therapy.
• Older adults may benefit particularly strongly. Patients older than 65 experienced what Bilchick described as a “remarkable” reduction in Afib risk of approximately 44%.
• GLP-1 medications may complement Afib procedures such as catheter ablation. Bilchick notes, “Even with these great ablation tools and techniques associated with the emergence of pulsed field ablation for Afib, if there is an underlying metabolic or inflammatory condition that’s promoting more arrhythmia, then being on these medications can help mitigate that and improve long-term success rates.”

What Could This Mean for You?

If you already take a GLP-1 medication and have Afib or are at increased risk for it, this research shows that you may be getting an added heart health benefit beyond weight loss or blood sugar control. Says Bilchick, “This study adds to our knowledge of the effect of these GLP-1 receptor agonists on reducing morbidity, mortality, and now, in this large study, reducing incident atrial fibrillation over the long term.”

More research is still needed, especially regarding how different GLP-1 medications, doses, and treatment durations affect weight loss, inflammation, glucose control, Afib risk, and long-term cardiovascular health. But the growing evidence suggests these medications may soon play a greater role in cardiovascular health and maintaining normal heart rhythm.