Obesity Pharmacotherapy and Cardiovascular Outcomes: Comparative Evidence From Randomized Trials Across Diverse Adult Patient Populations

This analysis evaluates cardiovascular outcomes of selected obesity medications to inform international interpretation of treatment benefit and harm. A descriptive secondary synthesis examined three published randomized trial comparisons from 2010 to 2023, representing 39,408 participants in SCOUT, CAMELLIA TIMI 61 and SELECT. Reported hazard ratios and confidence intervals were consolidated, checked and interpreted separately within each trial population. Sibutramine showed increased primary cardiovascular event hazard relative to placebo, with a hazard ratio of 1.16 and a 95 percent confidence interval from 1.03 to 1.31. Lorcaserin produced an estimate near unity at 0.99, with an interval from 0.85 to 1.14. Semaglutide reduced hazard, with an estimate of 0.80 and an interval from 0.72 to 0.90. Differences in eligibility, endpoint composition and observation duration bounded comparisons between medications. The synthesis distinguishes cardiovascular harm, uncertainty and benefit without interpreting these contrasts as direct comparative effectiveness. Its contribution is an explicit separation of cardiovascular evidence from assumptions based on weight management efficacy. International evidence appraisal should align treatment conclusions with the populations, endpoints and uncertainty directly represented.