Glucagon-Like Peptide-1 Receptor Agonists in the Prevention of Ischemic Stroke: Therapeutic Potential and Mechanisms

Numerous randomized controlled trials have demonstrated that glucagon-like peptide-1 receptor agonists (GLP-1RAs) can reduce the risk of stroke across various populations, likely because of their effectiveness in lowering the incidence of ischemic stroke events. This review aimed to consolidate recent advancements in clinical research on the role of GLP-1RAs in preventing ischemic stroke and examine the mechanisms involved. GLP-1RAs have been shown to significantly improve several risk factors associated with ischemic stroke, such as elevated body mass index, hyperglycemia, and renal dysfunction, while potentially mitigating hypertension and dyslipidemia. Additionally, GLP-1RAs play a role in modulating the initiation of inflammation, endothelial dysfunction, and vascular inflammation in atherosclerosis, which may contribute to their protective effects against ischemic stroke. Nevertheless, further investigations are required to substantiate the efficacy of GLP-1RAs in ischemic stroke prevention and comprehensively elucidate the underlying mechanisms.