Popular weight-loss drug Wegovy now approved for heart disease. Here's what we know.

The drug semaglutide, sold commercially as Ozempic or Wegovy, is well known for helping people lose significant amounts of weight quickly. Now the U.S. Food and Drug Administration has approved Wegovy, the version of semaglutide currently prescribed for weight loss, for preventing serious cardiovascular conditions in certain people who are at high risk.

The FDA's March 8 announcement will allow doctors to prescribe Novo Nordisk's Wegovy, which has a higher maximum dose of semaglutide than Ozempic does, to people who are overweight or obese and have had at least one cardiovascular event such as a heart attack or stroke. "It opens up a whole new group of patients for us," says Nicholas Marston, a cardiologist at Brigham and Women's Hospital.

Here's what we know about semaglutide's effects on cardiovascular disease and how it might work.

Who's a good candidate for taking the drug to reduce cardiac risk?

The FDA's approval expands the use of semaglutide to people with a BMI of 27 or higher (qualified as overweight or obese) with a history of cardiac events. But it's unknown whether the drug would work as well at preventing cardiovascular disease in people with lower BMIs. And it still hasn't been tested in people who may be at risk of cardiovascular disease but have not been diagnosed.

How effective is semaglutide at preventing cardiovascular problems?

The FDA based its decision on a 2023 trial called Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity (SELECT), in which Novo Nordisk tested Wegovy in more than 17,000 people. The participants all had a body mass index (BMI) of 27 or higher. But unlike previous trials of semaglutide, the SELECT participants did not have a history of diabetes, the disease for which the drug was initially approved in 2017.

The trial showed that people who took semaglutide lost almost 10% of their body weight on average compared to people who received a placebo. They had a 20% lower risk of heart attacks and strokes in the course of about three years, as well as significantly lower cholesterol and blood pressure.

In light of these findings, which were published in November, the FDA's decision to approve the drug for preventing heart problems "wasn't surprising at all," says Joseph Wu, a cardiologist at Stanford University. He says the 20% reduction in risk is impressive. By comparison, a 2023 trial of another new heart drug, bempedoic acid, found a 13% reduction in risk of heart attacks and strokes over three years. Wegovy may join the ranks of other effective cardiovascular drugs, such as beta blockers and statins.