Stopping GLP-1 drugs could increase heart attack risk for some, study says

A new study published in the Lancet Regional Health Europe suggests that stopping treatment with GLP-1 weight loss medications for type 2 diabetes patients may double the risk of heart attack, stroke or death. The study analyzed data from over 80,000 Italian patients with type 2 diabetes and no existing heart disease, gathered between 2004 and 2024.

Researchers found that four in every 100 people per year who stopped taking GLP-1 treatments experienced a non-fatal heart attack, stroke, or death, compared to about two in 100 of those who continued with the medication. Those with a body mass index (BMI) of 30 or higher, considered medically obese, showed a higher risk of adverse events when they stopped treatment compared to those with lower BMIs.

The majority of the participants who took GLP-1s continued treatment for about three years, while roughly 60% of those who did not stay on treatment stopped after around one year. While the study raises questions about the factors behind the increased risk, researchers caution that as an observational study, certain elements could not be determined.

The British Medical Journal notes that the study cannot definitively establish a direct causal link between discontinuing GLP-1 drugs and increased risk, nor can it explain why individuals stopped taking the medications, such as possible gastrointestinal side effects, high costs, or underlying health issues. Dr. Christopher Labos, a cardiologist and epidemiologist at McGill University, emphasizes that the Lancet study demonstrates the cardiovascular benefits of GLP-1 medications and warns against stopping them without valid reasons like side effects or ineffectiveness.

He notes that weight-loss drug users tend to regain weight at a rate of 0.4 kg per month after discontinuation, based on a prior study in the BMJ covering over 9,000 individuals. Labos stresses that these medications are chronic treatments for chronic conditions and should only be discontinued for specific issues. According to the Lancet study, patients who stopped GLP-1 treatment saw only modest changes in weight, blood sugar levels, and blood pressure, regardless of whether they experienced a heart attack, stroke, or death.

The study also cautions that the heightened risk of adverse events may not apply to individuals without type 2 diabetes who take GLP-1 medications for weight loss or other purposes. Further research is needed to determine whether stopping GLP-1 medications directly causes increased cardiovascular risk or if it serves as a marker of higher underlying risk.