Patient guide · Reviewed May 2026
GLP-1 Medications and Cardiovascular Health — What Australians Should Monitor
GLP-1 medications were developed for diabetes and weight management, but some of the strongest evidence in their favour concerns the heart. Semaglutide has been shown to reduce major cardiovascular events in high-risk populations — a benefit that now shapes PBS access to Wegovy in Australia.
This guide summarises the SELECT and LEADER trials in patient-friendly language, explains PBS cardiovascular criteria where relevant, and lists what to monitor — blood pressure, lipids, and resting heart rate — while on Ozempic, Wegovy, or Mounjaro.
Educational only; cardiovascular treatment decisions require your own clinician.
Published 2026-05-01 · Clinically reviewed 2026-05-31
Patient guide · Reviewed May 2026
Why Heart Health Matters on GLP-1 Therapy
Most Australians on GLP-1 medications already carry cardiovascular risk factors: type 2 diabetes, obesity, hypertension, or abnormal cholesterol. Weight loss…
Most Australians on GLP-1 medications already carry cardiovascular risk factors: type 2 diabetes, obesity, hypertension, or abnormal cholesterol. Weight loss and improved glycaemic control help, but GLP-1 drugs appear to have additional mechanisms — reduced inflammation, blood pressure effects, and favourable lipid changes.
Monitoring ensures you capture benefit and watch for issues such as symptomatic low blood pressure or heart rate changes during rapid weight loss.
SELECT Trial — Wegovy and Cardiovascular Events
The SELECT trial (NEJM, 2023) enrolled adults with overweight or obesity and established cardiovascular disease — but without diabetes. Semaglutide 2.4 mg weekly (Wegovy) reduced major adverse cardiovascular events (heart attack, stroke, cardiovascular death) by 20% over roughly 3.4 years compared with placebo.
This was the first evidence that weight-management-dose semaglutide protects the heart in non-diabetic high-risk patients. It underpins international enthusiasm for using GLP-1s in obesity with cardiovascular disease.
Patient guide · Reviewed May 2026
LEADER and SUSTAIN-6 — Ozempic in Diabetes
The LEADER trial (NEJM, 2016) studied semaglutide 1 mg (Ozempic dose) in type 2 diabetes with high cardiovascular risk. It reduced cardiovascular death,…
The LEADER trial (NEJM, 2016) studied semaglutide 1 mg (Ozempic dose) in type 2 diabetes with high cardiovascular risk. It reduced cardiovascular death, non-fatal heart attack, and non-fatal stroke by 26% versus placebo over 3.8 years.
SUSTAIN-6 earlier demonstrated similar direction of benefit with once-weekly semaglutide. Together, these trials established semaglutide as a cardioprotective diabetes therapy — not merely a glucose-lowering drug.
Wegovy PBS and Cardiovascular Criteria
Australian PBS listings for weight-management semaglutide have evolved and include restrictions tied to BMI, comorbidities, and in some streams established cardiovascular disease. Rules change — confirm current PBS criteria on the official PBS website or with your prescriber at the time of application.
Even if you pay privately, the SELECT evidence supports discussing Wegovy with your cardiologist or GP if you have prior heart attack, stroke, or peripheral vascular disease and struggle with weight.
Patient guide · Reviewed May 2026
What to Monitor — BP, Lipids, Heart Rate
- Blood pressure: Check at baseline, during dose escalation, and every 3–6 months. Weight loss often lowers BP — medication doses for hypertension may need reduction to avoid dizziness.
- Lipids: Fasting lipid panel at baseline and annually. Triglycerides often fall substantially; LDL may improve modestly. Statin therapy should continue unless your doctor advises otherwise.
- Resting heart rate: GLP-1s can increase resting heart rate by a few beats per minute on average. Report palpitations, chest pain, or syncope urgently.
- Weight and waist circumference: Track metabolic improvement alongside cardiovascular risk.
Mounjaro and Cardiovascular Outcomes
Tirzepatide cardiovascular outcome trials (SURPASS-CVOT and related studies) continue. Early data show favourable effects on blood pressure, lipids, and inflammatory markers. Monitoring principles match semaglutide until long-term outcome data are fully published.
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Frequently asked questions
Will Ozempic or Wegovy prevent a heart attack?
Trials show reduced risk of major cardiovascular events in high-risk groups — not guaranteed prevention for any individual. Continue blood pressure control, statins if prescribed, smoking cessation, and exercise.
My blood pressure dropped a lot on Wegovy — is that normal?
Weight loss and GLP-1 effects often lower blood pressure. Inform your GP; antihypertensive doses may need adjustment. Stand slowly to reduce dizziness.
Does GLP-1 therapy replace my statin?
No. Lipid-lowering therapy is complementary. GLP-1s improve some lipid parameters but do not replace indicated statins without medical review.
Why did my resting heart rate increase on Mounjaro?
A small average increase is reported in trials. Isolated mild rises are usually benign; report symptoms or large changes to your doctor.
Can I get Wegovy on PBS for heart disease without diabetes?
PBS criteria vary by indication and patient group. Ask your GP or cardiologist whether you meet current listings for cardiovascular risk, BMI, and prior weight-management attempts.
Reviewed against: SELECT trial (NEJM 2023); LEADER trial (NEJM 2016); SUSTAIN-6 (NEJM 2016); Australian PBS schedule Wegovy (semaglutide); TGA product information; SURPASS trial programme tirzepatide.
This article is for educational purposes only. It does not constitute medical advice. Always consult your GP or a specialist about your individual health circumstances.
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