GLP-1 Agonists and Cardiovascular Risk Markers in U.S. Adults: National Health and Nutrition Examination Survey...

Obesity and overweight remain major contributors to cardiovascular disease (CVD) in the United States. Glucagon-like peptide-1 (GLP-1) receptor agonists, originally developed for glycemic control in type 2 diabetes, have demonstrated cardiometabolic benefits. However, limited population-based evidence exists on their association with cardiovascular risk markers among U.S. adults with overweight or obesity. This study aimed to evaluate the associations between GLP-1 receptor agonist use and cardiovascular risk markers (systolic and diastolic blood pressure, total cholesterol, high-density lipoprotein {HDL} cholesterol, and hemoglobin A1c) in a nationally representative sample of U.S. adults aged ≥18 years with overweight or obesity.

Data from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were analyzed using survey-weighted linear regression. Adults aged ≥18 years with overweight or obesity and complete biomarker data were included. Primary exposure was GLP-1 use; outcomes included systolic and diastolic blood pressure, total cholesterol, HDL cholesterol, and hemoglobin A1c.

Among 16,744 unweighted participants, GLP-1 users had significantly lower systolic blood pressure (β = -5.44, p<0.05) compared to non-users. No statistically significant differences were observed in lipid profiles or A1c after adjustment. Age, BMI, insurance status, and diabetes diagnosis were significant covariates.

GLP-1 receptor agonist use was associated with lower systolic blood pressure among adults with overweight or obesity. These findings highlight population-level associations that may inform future research on the cardiometabolic impact of GLP-1 therapies.