SELECT — Semaglutide and cardiovascular outcomes in obesity without diabetes
In plain English
SELECT tested whether weight-loss medication actually prevents heart attacks: 17,604 adults with established cardiovascular disease and overweight or obesity — but not diabetes — were randomised to weekly semaglutide 2.4 mg or placebo and followed for over three years. Semaglutide cut major adverse cardiovascular events (heart attack, stroke, cardiovascular death) by 20%. It was the first hard-outcome proof that treating obesity with a GLP-1 drug reduces cardiovascular events, moving these medicines from cosmetic to genuinely preventive.
Why it matters
In people with obesity and heart disease, semaglutide cut major cardiovascular events 20% over ~3 years.
Informs: Weight Loss·Heart Disease·Diabetes
Provenance
- Design
- Randomised controlled trial
- Sample size (n)
- 17,604
- Follow-up
- 3.3 years
- Peer-reviewed
- Yes
- Replications
- 1
- Funding
- Industry-funded
- Funders
- Novo Nordisk
- Institutions
- Cleveland Clinic, University College London, University of Edinburgh
decades.plus score
A transparent 0–100 weighted sum across six components. Higher scores reflect bigger, cleaner, more replicated work.
Caveats
Manufacturer-funded (Novo Nordisk), which our score penalises. Participants all had pre-existing cardiovascular disease, so the result may not extend to lower-risk people, and how much of the benefit comes from weight loss itself versus the drug's other effects on inflammation and blood vessels is still being untangled.
