Study points to broader heart role for GLP-1 drugs

Adults with a BMI of 25–26.9 generally cannot receive GLP-1 medicines for weight management. Yet researchers found that roughly half of this group showed excess remnant cholesterol, mild ongoing inflammation or both. These markers were tied to coronary risk comparable to that of participants who qualified under existing prescribing criteria.

The analysis covered 313,145 adults in two long-running studies from Denmark and the U.K. None had diabetes or coronary disease when they entered the research. Over more than 10 years of observation, 23,134 participants experienced a qualifying heart outcome, including diagnosis of coronary disease, a heart attack, an artery-opening procedure, bypass surgery or cardiovascular death. Among otherwise ineligible participants with both risk markers, coronary disease rates were 41% higher in the Danish cohort and 47% higher in the British cohort than among ineligible peers with healthier marker levels.

Semaglutide and tirzepatide are currently authorized for weight management at a BMI of ≥30, or ≥27 when another weight-related condition is present. The findings support studying whether eligibility could eventually include some adults below those thresholds. Because the analysis observed health outcomes rather than testing treatment, clinical trials must determine whether these medicines actually lower risk in that group.