Semaglutide Shows Consistent Heart Benefits Across Frailty Levels
A secondary analysis of the SELECT trial found that semaglutide reduced cardiovascular events consistently across frailty levels in adults with heart disease and overweight or obesity. The most frail participants experienced greater quality-of-life improvements and lower discontinuation rates due to adverse events. Researchers say this reassures that frail patients can benefit from the drug.
The analysis drew on data from the SELECT trial, which enrolled over 17,600 adults with a body mass index of 27 or higher and established cardiovascular disease. Researchers categorized frailty by counting accumulated age-related deficits, then compared semaglutide against placebo for heart outcomes and quality-of-life measures. Notably, the most frail participants showed the largest improvements in mobility, self-care, and daily activities, and they were less likely to stop treatment due to side effects than non-frail peers. The authors also observed that semaglutide use was associated with a higher chance of frailty status improving over time, suggesting the drug might help modify frailty trajectories.
This finding could reassure clinicians who hesitate to prescribe GLP-1 therapies to frail older adults, potentially expanding access to a proven cardiovascular treatment. Patients with frailty may gain meaningful quality-of-life benefits, not just reduced heart events. However, real-world use still requires careful monitoring, as frailty often coexists with complex medication regimens and nutritional vulnerabilities. The results may also encourage broader screening for frailty in cardiology practice, shifting how risk is assessed and managed.