Key result
Semaglutide reduces body weight by ~7% vs. placebo over 52 weeks in obese HFpEF patients.
Why the study?
Effective HFpEF treatments remain limited, especially in obese patients where obesity is strongly linked to HFpEF pathogenesis and exacerbates diastolic dysfunction.
Does semaglutide reduce body weight and improve clinical outcomes in obese patients with heart failure with preserved ejection fraction?
Meta-Analysis (n=1,463)
Does semaglutide reduce body weight and improve clinical outcomes in obese patients with heart failure with preserved ejection fraction?
Effect estimate: MD -6.68 (95% CI -10.51, -2.85)
p-value: p=0.0006
In obese patients with HFpEF, semaglutide significantly reduces body weight, improves functional capacity and quality of life, and lowers heart failure hospitalizations.
Supports semaglutide for weight reduction in obese HFpEF; extends prior RCTs with pooled confirmation of benefit.
Abstract Background: Heart failure with preserved ejection fraction (HFpEF) affects nearly half of heart failure patients, with over 80% being either overweight or obese. Obesity is strongly associated with the pathogenesis of HFpEF, exacerbating diastolic dysfunction. Despite available therapies, effective treatments are limited, particularly in obese individuals. This systematic review and meta-analysis aimed to evaluate the safety and efficacy of semaglutide in obese patients with HFpEF. Methods: A comprehensive literature search was conducted in PubMed, Google Scholar, and the Cochrane Library, adhering to PRISMA guidelines. Three studies (2 RCTs and 1 observational study) with 1,463 patients (677 in the semaglutide group, 786 in placebo) were included. Outcomes included percentage change in body weight, 6-minute walk distance, heart failure hospitalizations, cardiovascular mortality, and quality of life improvements. A random effects model was used, and heterogeneity was assessed using I² statistics. Results: The meta-analysis demonstrated that semaglutide significantly reduced body weight (MD = -6.68; P = 0.0006) and improved 6-minute walk distance (MD = 16.37; P < 0.00001). Semaglutide also substantially reduced the risk of heart failure hospitalizations (RR = 0.28; P = 0.0005). However, no statistically significant reduction was observed in cardiovascular mortality (RR = 0.27; P = 0.16). Additionally, patients experienced significant improvements in quality of life, as measured by the Kansas City Cardiomyopathy Questionnaire clinical summary score (KCCQ-CSS) (RR = 0.30; P < 0.0001). Conclusion: Semaglutide shows promising effects in improving clinical outcomes, particularly in reducing body weight, enhancing functional capacity, and lowering heart failure-related hospitalizations in obese HFpEF patients. However, its impact on cardiovascular mortality remains inconclusive, warranting further research.
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Altamimi et al. (2025) conducted a meta-analysis in Heart failure with preserved ejection fraction and obesity (n=1,463). Semaglutide vs. Placebo was evaluated on Percentage change in body weight from baseline to week 52 (MD -6.68, 95% CI -10.51, -2.85, p=0.0006). Semaglutide significantly reduced body weight by a mean difference of 6.68% compared to placebo over 52 weeks in obese patients with heart failure with preserved ejection fraction.
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