SAIMSARA Journal · Feb 19, 2026
GLP-1 Receptor Agonists and Cardiovascular Effects: Scoping Review with ☸SAIMSARA
By SAIMSARA
To synthesize contemporary research findings regarding the impact of glucagon-like peptide-1 (GLP-1) receptor agonists on cardiovascular outcomes, including major adverse cardiovascular events (MACE), heart failure, arrhythmias, and peripheral vascular health across diverse clinical populations. The review utilises 948 original studies with 24310384 total participants (topic deduplicated ΣN). The mapped evidence indicates that GLP-1 receptor agonists are associated with consistent reductions in MACE, cardiovascular mortality, and stroke across type 2 diabetes, obesity, and established atherosclerotic cardiovascular disease populations, with representative hazard ratios as low as 0.466 in high-risk atherosclerotic cohorts and 26% to 42% reductions in ischemic stroke risk. Dominant topic signals support anti-atherosclerotic, anti-inflammatory, endothelial, and lipid-handling mechanisms, alongside emerging benefits in heart failure with preserved ejection fraction, peripheral artery disease, chronic kidney disease, and post-myocardial infarction secondary prevention. The evidence map also highlights important heterogeneity, including mixed atrial fibrillation findings, uncertain perioperative cardioprotection, chronotropic effects, and persistent prescribing gaps with uptake often below 10% to 20% despite guideline-supported indications. Clinically, these findings support integration of GLP-1 receptor agonists into multidisciplinary cardiorenal pathways, with pharmacist- and cardiology-led programs showing improved evidence-based prescribing. Overall, the synthesis suggests a broad cardioprotective signal that extends beyond glycemic control, tempered by disparities in access and unresolved arrhythmic and perioperative questions. Future research should prioritize randomized confirmation of benefit in non-diabetic peripheral artery disease, dual-agonist hemodynamic safety, perioperative arrhythmia prevention, and equitable implementation strategies to close observed racial, socioeconomic, and age-related access gaps.