Does Semaglutide Reduce the Risk of Strokes?

Key takeaways:

Semaglutide is a medication used to treat Type 2 diabetes (Ozempic, Rybelsus) and to help people lose weight (Wegovy). The injectable forms, Wegovy and Ozempic, are also approved for their cardiovascular benefits in certain people with heart disease.
During clinical trials, people receiving Wegovy or Ozempic had a lower rate of strokes compared to those in the placebo groups. But Ozempic’s impact was significant, with a 39% reduction in stroke rate in people with Type 2 diabetes and heart disease.
More research is needed to understand how semaglutide affects the risk of strokes. It’s also important to figure out who might benefit from semaglutide and what kinds of strokes it may help prevent.
Even if you don’t have heart disease or diabetes, semaglutide can have a positive effect on several contributors to stroke risk. Examples of these include blood glucose (sugar) levels, body weight, inflammation, blood pressure, and cholesterol.

A stroke can be a devastating and life-altering event, impacting nearly 800,000 people in the U.S. every year. Even if you’ve never experienced a stroke, taking preventative measures is crucial, especially if you’re at risk.

Over the past decade, research has highlighted the cardiovascular benefits of semaglutide (Wegovy, Ozempic). For certain people with heart disease, semaglutide has been shown to lower the risk of major cardiovascular events (heart attack, stroke, or cardiovascular death), or MACE. But can semaglutide actually lower your risk of having a stroke?

The short answer: Possibly. There’s some evidence that semaglutide may have stroke-specific benefits for certain people. Here’s what you should know.

What is semaglutide?

Semaglutide is a medication that belongs to the glucagon-like peptide-1 (GLP-1) agonist class. It’s available as an injection (Ozempic) and oral pill (Rybelsus) for Type 2 diabetes. And a higher-dose injection (Wegovy) is also approved for weight loss.

Semaglutide works by telling the pancreas to release insulin, decreasing glucose (sugar) production in the liver, and slowing the passage of food from the stomach. It also works on areas of the brain that regulate your appetite and feelings of fullness.

Together, these effects can help lower blood glucose levels and cause weight loss. But researchers are finding that semaglutide can possibly do even more to benefit the heart and blood vessels, such as:

Reducing inflammation
Making blood clotting cells less likely to clump together
Improving blood pressure and cholesterol levels

Because of this, both Wegovy and Ozempic are also approved to lower the risk of serious cardiovascular problems. And Rybelsus is currently being studied for this use. But what about strokes specifically?

EXPERT PICKS: WHAT TO READ NEXT

Added benefits: If you have heart disease, semaglutide (Ozempic, Wegovy) can have additional benefits beyond weight loss. Read more about what semaglutide’s cardiovascular benefits could mean for you.
Recipe for success: Experts discuss the best diets for stroke prevention and recovery — including foods that are best to avoid.
Key differences: Wegovy and Ozempic both contain the same active ingredient: semaglutide. But, they aren’t exactly the same. Read more about the key differences between Wegovy and Ozempic.

The link between semaglutide, diabetes, weight, and stroke

Semaglutide has proven benefits for diabetes, heart disease, and a high body mass index (BMI), which are all risk factors for stroke.

How does diabetes affect stroke risk?

Compared to people without diabetes, you’re twice as likely to have a stroke if you have diabetes. This increased risk is from the long-term effects of high blood glucose levels, which can damage blood vessels in the brain.

How does body weight affect stroke risk?

Body weight can also influence stroke risk. And having a high BMI can increase your risk of the leading cause of strokes — high blood pressure. Other stroke risk factors, such as diabetes and high cholesterol, are also commonly linked to excess body weight. In this case, even a small amount of weight loss can benefit your heart and blood vessels.

Can semaglutide prevent strokes?

The Wegovy and Ozempic clinical trials both included people with heart disease and other risk factors for stroke. And, having diabetes, especially with high blood pressure, significantly increases stroke risk. So these trials provide some data about whether semaglutide may have stroke benefits in people who have a high risk of strokes.

Beyond helping with weight loss, semaglutide also addresses many of the risk factors for strokes. After all, semaglutide lowers blood glucose, inflammation, blood pressure, and cholesterol. But experts think that semaglutide’s potential stroke risk benefits even go beyond these effects. Here’s what the evidence shows so far.

Semaglutide and stroke prevention in people with diabetes

Semaglutide seems to have the biggest effect on stroke rates for people with both Type 2 diabetes and heart disease.

During the Ozempic trial, participants with Type 2 diabetes receiving Ozempic saw a 39% reduction in the rate of nonfatal strokes, which was considered to be significant. A deeper dive suggests that semaglutide may be particularly helpful against strokes involving small blood vessels in the brain. This type of stroke tends to be more common in people with diabetes.

Semaglutide and stroke prevention without diabetes

Semaglutide can be an effective tool for weight loss and for lowering the risk of serious cardiovascular problems.

In the Wegovy trial, people without diabetes who received Wegovy had a slightly lower rate of strokes. But it’s not known if this difference was due to chance or Wegovy.

More research is needed to see if semaglutide can significantly reduce stroke rates in people without diabetes. But even if you don’t have diabetes, semaglutide can still have beneficial effects on stroke risk factors by reducing:

Body weight and waist size
Blood pressure
Cholesterol
Higher than normal blood glucose levels (called prediabetes)
Inflammation

Can semaglutide lower your risk of having another stroke?

Possibly. Most people in the Wegovy and Ozempic trials didn’t have a prior history of stroke. But some findings suggest that people with Type 2 diabetes who’ve previously had a stroke might benefit from semaglutide. Additional studies are needed to confirm this benefit.

Who could benefit from semaglutide for stroke benefits?

It’s possible that semaglutide may help lower the risk of having a stroke. But more research is needed to know for sure. Even so, it can positively impact factors that contribute to stroke risk. Here’s who could potentially benefit:

Adults with diabetes and heart disease: Semaglutide has been shown to lower the risk of serious cardiovascular problems in this group. It may also help lower the risk of stroke, especially if you have multiple risk factors.
Adults with a high BMI and heart disease: Semaglutide can also lower the risk of serious cardiovascular problems in this group. More research is needed to confirm its stroke-specific benefits. But semaglutide can help reduce stroke risk factors, such as body weight, high blood pressure, and elevated blood glucose levels.
Adults with a high BMI: People without heart disease weren’t included in the cardiovascular trials, so more research is needed in this group. But semaglutide can help you meet your body weight goals. This can lower the chances of developing other stroke risk factors, such as high blood pressure, high cholesterol, and diabetes.

The bottom line

Semaglutide (Ozempic, Wegovy) is currently approved to lower the risk of serious cardiovascular problems in certain people with heart disease. More research is needed to see if it can lower the risk of stroke. But some findings suggest that it may have stroke-specific benefits for certain groups of people.

Talk to your healthcare team for information about whether semaglutide is right for you.

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Written by:

Alyssa Billingsley, PharmD

Alyssa Billingsley, PharmD, is the director of pharmacy content for GoodRx. She has over a decade of experience as a pharmacist and has worked in clinical, academic, and administrative roles.

Reviewed by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. A pulmonologist and hospitalist, she practiced and taught clinical medicine at hospitals in London for a decade before entering a career in health education and technology.

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