Emulated Effects of Glucagon-Like Peptide 1 Receptor Agonist Therapy in the General Population

Schrage, B; Lackner, MK; Hoshiyar, A; de Lemos, JA; Engström, G; Grossmann, E; Ittermann, T; Leistner, D; Lorenz, T; Lyngbakken, MN; Omland, T; Panagiotakos, DB; Risérus, U; Schöttker, B; Söderberg, S; Thorand, B; Wannamethee, SG; Ziegler, A; Ojeda, FM; Blankenberg, S; Magnussen, C

doi:10.1016/j.jacc.2026.01.055

Prevention & lipids

Emulated Effects of Glucagon-Like Peptide 1 Receptor Agonist Therapy in the General Population

J Am Coll CardiolPublished 11 Mar 2026Modelling study

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Authors' conclusion

In appropriately selected individuals at high CVD risk, GLP-1RA therapy may complement existing primary prevention strategies

Study context

Population: Cardiovascular disease (CVD)-free individuals with body mass index (BMI) ≥27 kg/m² and SCORE2-derived baseline risk ≥7.5%, 2 contemporary health examination surveys21,720 in primary analysis
Participants: 200,012 individuals

Comparison: Emulated GLP-1RA therapy vs observed
Outcome: 10-year CVD incidence
Follow-up: 10 years

Methodological detailsemulation of GLP-1RA therapy in population cohorts, risk-factor changes from SELECT trial applied, prespecified risk factors, sex-stratified, placebo-adjusted, Model fitted in 610,789 CVD-free individuals from European and North American Global Cardiovascular Risk Consortium cohorts

Emulation of GLP-1RA therapy in population cohorts
Risk-factor changes from SELECT trial applied
Prespecified risk factors
Sex-stratified, placebo-adjusted
Model fitted in 610,789 CVD-free individuals from European and North American Global Cardiovascular Risk Consortium cohorts

Main finding

As reported in the abstract

Absolute reduction

2.99%

95% CI 2.67%–3.31%

By group

Observed13.82%95% CI 11.94%–15.71%

Emulated GLP-1RA therapy10.83%95% CI 9.27%–12.39%

Further findings

Absolute reduction in projected 10-year CVD incidence, by sex (subgroup)

Absolute reduction, men: 3.14% (95% CI: 2.82%-3.47%)
Absolute reduction, women: 2.7% (95% CI: 2.23%-3.16%)
Relative reduction, men vs women: 21% vs 23%

Nonobese and lower SCORE2 groups; reduced compliance

Modeled risk reductions attenuated in nonobese and lower SCORE2 groups and diminished further with lower compliance assumptions

Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.

Original publication

Emulated Effects of Glucagon-Like Peptide 1 Receptor Agonist Therapy in the General Population. J Am Coll Cardiol. Published 11 March 2026. doi:10.1016/j.jacc.2026.01.055

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Summarised from the published abstract; every number is checked against it