If you’ve heard about semaglutide medications like Wegovy or Ozempic, you may know them as powerful tools for weight management and type 2 diabetes. However, recent research suggests these medications may also help improve heart health. Semaglutide has shown promising effects on cholesterol levels, triglycerides, and other cardiovascular risk factors, helping to create a healthier metabolic profile for those at risk of heart disease.

At Genesis Lifestyle Medicine, we believe in providing a holistic approach to wellness, addressing root causes like obesity to support better health from the inside out. For those concerned about cholesterol levels and cardiovascular risks, exploring semaglutide could be an important step. Here, we’ll discuss how semaglutide impacts cholesterol.

A retrospective study on semaglutide and cardiovascular health

To understand the potential impact of semaglutide on cholesterol and heart health, a recent retrospective study evaluated the effects of this drug on cardiovascular risk factors. This study, presented at the European Congress on Obesity, involved analyzing the data of 93 patients with a body mass index (BMI) of 27 or higher, all with no prior history of cardiovascular disease. By examining the patients’ demographic, clinical, and lipid panel data, researchers could assess semaglutide’s effect on cholesterol and cardiovascular risk.

The researchers calculated each patient’s 10-year atherosclerotic cardiovascular disease (ASCVD) risk using a tool created by the American College of Cardiology. This ASCVD estimator predicts a person’s likelihood of developing heart disease over the next decade based on factors such as blood pressure, cholesterol levels, age, and smoking status. Each patient's baseline risk was calculated before starting semaglutide and then again after one year of consistent use. Other cardiovascular markers, including LDL cholesterol, triglycerides, HDL cholesterol, blood pressure, and more, were also measured.

After a year of semaglutide use, the participants saw a notable decrease in their 10-year ASCVD risk, dropping from an average of 7.64% to 6.26%—a reduction of 1.38%. This improvement suggests that semaglutide may significantly lower the risk of heart disease in people with higher BMI who are at risk of developing cardiovascular issues. Additionally, the study found that the participants experienced a 10.9% average reduction in body weight and improved blood pressure, total cholesterol, and HbA1c levels.

How semaglutide affects cholesterol levels

Reducing LDL cholesterol

One of the ways semaglutide benefits cholesterol levels is by decreasing low-density lipoprotein (LDL) cholesterol, often known as "bad cholesterol." LDL cholesterol contributes to the buildup of atherosclerotic plaques in your arteries, which can obstruct blood flow and increase your risk of heart attacks. Semaglutide mimics a naturally occurring hormone in your body, glucagon-like peptide-1 (GLP-1), which is involved in insulin release and blood sugar regulation.

In addition to lowering blood glucose, semaglutide can help modulate lipid levels. When semaglutide improves insulin sensitivity, your body’s cells respond better to insulin, lowering glucose levels and indirectly influencing the body's lipid profile. Over time, this can significantly reduce LDL cholesterol, which plays a crucial role in preventing cardiovascular disease.

Lowering triglyceride levels

Another important way semaglutide impacts cholesterol is by lowering triglycerides, a type of fat in your blood that, in high amounts, is associated with an increased risk of heart disease. Elevated triglycerides are often linked to insulin resistance, a condition common in those with obesity and type 2 diabetes. By enhancing your body’s sensitivity to insulin, semaglutide helps reduce the production and accumulation of triglycerides.

Patients on semaglutide experience a measurable decline in triglyceride levels after consistent use over months. Lower triglycerides contribute to healthier blood vessels, decreasing the strain on your cardiovascular system and supporting heart health over time.

Raising HDL cholesterol

While lowering LDL and triglycerides is important, increasing high-density lipoprotein (HDL) cholesterol—or “good” cholesterol—is also beneficial. HDL cholesterol helps remove excess cholesterol from your bloodstream, transporting it back to the liver for processing. This process helps reduce plaque buildup in your arteries, enhancing overall cardiovascular health.

Research has shown that semaglutide may have a modest effect on HDL cholesterol levels. While this increase may not be as pronounced as the reductions in LDL and triglycerides, any boost in HDL can still contribute to a more balanced lipid profile. This supports heart health by providing a complementary mechanism to offset the risks posed by high LDL levels.

Reducing overall cholesterol levels

Semaglutide’s primary role as a weight-loss drug indirectly influences cholesterol by reducing overall body fat. Excess body fat, especially around the abdomen, can contribute to higher cholesterol levels and an increased risk of cardiovascular issues. By assisting with weight loss, semaglutide helps reduce fat stores, which lowers cholesterol levels and improves your body’s ability to regulate lipids effectively.

Research supports that people who lose weight with semaglutide experience lower LDL and triglycerides and a decrease in their total cholesterol. This can be attributed to improved metabolic function and a lower demand on the liver to process excess lipids. Through weight loss, semaglutide offers an all-encompassing approach to better cholesterol management.

The broader benefits of improving cholesterol levels:

• Enhancing cardiovascular health: The primary benefit of lowering LDL cholesterol and triglycerides and increasing HDL is a reduced risk of heart disease. Improved cholesterol levels directly influence cardiovascular health by minimizing plaque buildup in your arteries, which can prevent conditions like heart attacks and strokes.
  
• Supporting metabolic health: With a more balanced lipid profile, you’ll likely see improvements in metabolic health. A healthier metabolic system can support weight management, improve energy levels, and decrease your risk of chronic diseases.
  
• Supporting arterial health: Lower cholesterol levels help reduce systemic inflammation in your body, a factor closely linked to arterial stiffness and other cardiovascular issues. By improving your cholesterol profile, semaglutide indirectly supports healthier, more flexible arteries, which lowers blood pressure and decreases strain on your heart.

Semaglutide offers promising benefits for weight loss and blood sugar control and improving cholesterol levels—an essential factor in cardiovascular health. Through mechanisms that lower LDL and triglycerides, raise HDL cholesterol, and address insulin resistance, semaglutide can support a more balanced lipid profile and healthier heart.

Schedule a consultation at Genesis Lifestyle Medicine, we support you in achieving a healthier, more vibrant life. By integrating evidence-based treatments like GLP-1 medications into your wellness journey, we can work together to address core health concerns, improve your cholesterol, and promote your heart health in a comprehensive and sustainable way.