Semaglutide and Heart Health: The SELECT Trial Results

The SELECT Trial: Semaglutide and Cardiovascular Outcomes

The SELECT trial (Semaglutide Effects on Cardiovascular Outcomes in People with Overweight or Obesity) was a landmark study that changed how we think about GLP-1 medications. Published in the New England Journal of Medicine in December 2023, it was the first trial to demonstrate that a weight loss medication could reduce the risk of heart attacks, strokes, and cardiovascular death.

Study Design

SELECT enrolled **17,604 adults** aged 45 and older with:

Participants were randomly assigned to receive semaglutide 2.4 mg or placebo weekly, and were followed for a mean of approximately 33 months.

Primary Results

The primary endpoint was a composite of cardiovascular death, nonfatal heart attack, and nonfatal stroke (known as 3-point MACE).

**Semaglutide reduced major cardiovascular events by 20%:**

*Source: Lincoff AM, et al. "Semaglutide and Cardiovascular Outcomes in Obesity without Diabetes." NEJM 2023;389:2221-2232.*

Why This Matters

Before SELECT, weight loss medications were evaluated primarily on their ability to reduce body weight. SELECT demonstrated that the benefits extend to hard cardiovascular outcomes -- meaning fewer heart attacks, strokes, and deaths from heart disease.

Based on these results, the FDA expanded Wegovy's label on March 8, 2024, to include a new indication: **reducing the risk of major adverse cardiovascular events in adults with established cardiovascular disease and obesity or overweight.**

This was the first time a weight management medication received an FDA-approved cardiovascular indication.

Important Context

For Patients with Heart Disease and Obesity

If you have both cardiovascular disease and obesity or overweight, the SELECT trial provides strong evidence that semaglutide can reduce your risk of future heart events. This is a conversation worth having with your cardiologist or primary care provider.

*This article summarizes published clinical trial data and does not constitute medical advice. Consult with a healthcare provider about your individual risk factors and treatment options.*