GLP-1 receptor agonists in cardiovascular disease: a guide for cardiologists.

Obesity is a global epidemic, which, directly and indirectly, contributes to almost all cardiovascular diseases, including atherosclerotic cardiovascular disease, heart failure and atrial fibrillation. Reduction of weight is associated with substantial improvements in cardiometabolic risk factors, including blood pressure and glycaemic control, with over 10% weight loss required to see improvement in rates of major adverse cardiovascular events. Glucagon-like peptide-1 (GLP-1) receptor agonists have changed the landscape of type 2 diabetes and obesity management, showing significant benefit in glycaemic control and weight loss. Their potential for cardiovascular benefits means that they will likely have a central role in the management of patients with obesity-related cardiovascular diseases. This review summarises currently available GLP-1-based pharmacotherapies and highlights recent trials demonstrating cardiovascular benefits, and also provides practical guidance for patient selection, available agents, their initiation and patient monitoring. This will serve as an aid for cardiovascular clinicians, who will inevitably encounter patients suitable for, or already using, these drugs in their daily practice.