Treatment with the anti-obesity medications semaglutid (sold as Ozempic and Wegovy) or tirzepatid (Mounjaro) can reduce health risks for patients with heart failure by more than 40 percent. These finding come from a study by researchers at the Technical University of Munich (TUM). The medication can drastically reduce the risk of being hospitalized for heart failure or dying.
Semaglutid and related medications are widely used to treat diabetes and obesity. Their potential effects beyond weight loss are now being closely studied. Still, professional societies and regulatory authorities have urged caution. With regard to treating heart failure, cardiology societies have noted that the existing evidence base remains limited.
"Together with our colleagues at Harvard Medical School, we have created a solid evidence base for using these weight-loss medications in heart failure," says Professor Heribert Schunkert, Director of the Department of Cardiovascular Diseases at the TUM University Hospital German Heart Center. "In patients with heart failure with preserved ejection fraction, both drugs have shown a clear protective effect that supports their use. Our analysis of around 100,000 patients provides a robust basis for reassessing an indication expansion and new indication approval in heart failure."
The study focused on heart failure with preserved ejection fraction or HFpEF, in which the heart's ability to pump remains intact but the stiffened heart muscle does not fill properly with blood. HFpEF affects more than 30 million people worldwide. To date, there are only a few effective treatment options for this form of the disease.
Large-scale Database study provides solid evidence for use in heart failure
Published in JAMA, the study examined the effects of the drugs semaglutide, brand name Ozempic and Wegovy, and tirzepatide, known as Mounjaro, in patients with this specific form of heart failure. The researchers analyzed three national US insurance claims databases. Their models first confirmed findings from earlier trials in patients with obesity or diabetes, then extended the analysis to populations excluded from clinical trials and to additional outcomes, such as hospitalization for heart failure and mortality.
Treatment with both drugs led to a more than 40 percent reduction in the risk of hospitalization for heart failure or death compared with another diabetes drug that had shown no effect on heart failure outcomes in previous studies.
"Currently, HFpEF can be treated with a few drugs only. At the same time, an increasing number of patients suffers from obesity and diabetes, which further worsens outcomes. In Germany, heart failure is the leading cause for hospitalizations and a major driver of health care expenditure. Our study shows that these drugs are highly effective, which expands treatment options and could prevent many hospital admissions," says Dr. Nils Krüger, resident physician at the TUM University Hospital German Heart Center and lead author of the study.
Data-driven approaches to drug approval
The study drew on patient populations nearly 20 times larger than those in traditional clinical trials. This allowed researchers to capture clinical practice and demonstrate that the benefits seen in pivotal trials also apply to broader patient groups. "The future belongs to such data‑driven approaches - alongside traditional trials, they can help ensure that findings from basic research feed into patient care more quickly," explains Professor Schunkert.
From the researchers' perspective, such analyses are also becoming increasingly relevant for Germany. The Health Data Utilization Act provides that anonymized health insurance data will in future be made systematically available for such research projects, while strictly protecting sensitive personal data. "We use these large data to investigate the safety and effectiveness of medications in clinical practice," says Dr. Krüger.
Krüger et al: Semaglutide and Tirzepatide in Patients With Heart Failure With Preserved Ejection Fraction, published in JAMA, 31. August 2025. DOI: 10.1001/jama.2025.14092
