Efficacy of GLP ‐1 receptor agonists in patients with obesity and heart failure with preserved ejection fraction: A systematic review and meta‐analysis of randomised controlled trials
Authors' conclusion
GLP-1 RAs significantly reduced heart failure events, improved KCCQ-CSS score, reduced body weight, and improved 6MWD compared to placebo.
Study context
- Population
- Obese patients with heart failure with preserved ejection fraction (HFpEF)
- Participants
- 1,876 patients3 randomised controlled trials (RCTs)
- Comparison
- GLP-1 RA vs placebo
- GLP-1 RAn = 937
- Outcome
- Cardiovascular and all-cause mortality
- Follow-up
- Mean 69.3 weeks
Methodological detailsrandom-effects model
- Random-effects model
Pooled result
As reported in the abstract
mean follow-up 69.3 weeks
- No difference between groups in cardiovascular mortality: RR 0.79 (95% CI 0.22-2.88)
- p = 0.72
- No difference between groups in all-cause mortality: RR 0.98 (95% CI 0.58-1.64)
- p = 0.93
Further pooled results
| Outcome | MD (kg) (95% CI) | |
|---|---|---|
| Body weight | −9.76 (−13.50 to −6.01) | |
| −20−10010Difference, kg (linear scale) |
| Outcome | MD (m) (95% CI) | |
|---|---|---|
| Functional capacity (6MWD) | 16.54 (10.18–22.91) | |
| −100102030Difference, m (linear scale) |
Safety
Serious adverse events
- No difference between groups in serious AEs: RR 0.66 (95% CI 0.40-1.09)
- P = 0.10
Drug discontinuation due to AEs
- GLP-1 RAs increased risk of discontinuation due to AEs: RR 2.36 (95% CI 1.16-4.79)
- P = 0.02
- Primarily gastrointestinal: RR 4.01 (95% CI 2.15-7.45)
- P < 0.01
Original publication
Efficacy of GLP ‐1 receptor agonists in patients with obesity and heart failure with preserved ejection fraction: A systematic review and meta‐analysis of randomised controlled trials. Diabetes Obes Metab. Published 12 September 2025. doi:10.
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