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GLP-1 Drugs Reduce Heart Events More in Asian Populations Than in White or Black Populations

RPEP-152702026Hasebe, Masashi; Su, Chen-Yang; Kamido, Hisashi; Yabe, Daisuke; Yoshiji, Satoshi
evidence
The takeaway

GLP-1 RAs reduced MACE in Asians (HR 0.73), Whites (HR 0.86), and Black/African Americans (HR 0.88, NS), with Asian populations showing significantly greater relative risk reduction (RHR 0.84 vs White).

27% vs 14% CV reduction

Asian populations showed nearly double the cardiovascular risk reduction from GLP-1 drugs compared to White populations (HR 0.73 vs 0.86)

What the researchers found

GLP-1 RA MACE reduction: Asian HR 0.73 (p<0.001); White HR 0.86 (p<0.001); Black HR 0.88 (p=0.34). Asian vs White RHR 0.84 (p=0.027), indicating significantly greater benefit in Asians.

Why it matters

Racial differences in drug response affect global health policy. Greater GLP-1 cardiovascular benefit in Asians supports prioritizing these drugs in Asian populations.

How the study worked

Meta-analysis of 9 randomized placebo-controlled GLP-1 RA trials including SOUL, with race-stratified MACE outcomes from 8,164 Asian, 4,036 Black, and 62,503 White participants.

What this study cannot tell us

Race as a variable is imprecise. Smaller Black participant numbers limited power. Cannot determine biological vs socioeconomic drivers of differences.

How to read the evidence

Meta-analysis of 9 RCTs with race-stratified data. High-quality evidence for the overall finding; Asian vs White difference is novel.

When this study was published

Published in 2025 including latest SOUL trial.

The bigger picture

Understanding racial differences in GLP-1 drug benefits enables precision prescribing and equitable allocation of these drugs globally.

Questions still open

  • What biological factors explain greater GLP-1 CV benefit in Asians?
  • Should GLP-1 drugs be prioritized in Asian cardiovascular guidelines?
  • Do racial differences extend to non-CV GLP-1 benefits?

Common questions

Do GLP-1 drugs work the same for all races?
They reduce heart attacks and strokes across all races, but Asian patients appear to benefit significantly more (27% reduction vs 14% in White patients and 12% in Black patients).
Why do Asians benefit more?
The biological reason is unknown. It could relate to differences in GLP-1 receptor biology, body composition, metabolic processing, or other factors that need further research.

Read the original research

GLP-1 receptor agonists and cardiovascular outcomes in Asian, Black or African American, and White populations: An updated meta-analysis including the SOUL trial.

Diabetes, obesity & metabolism

View on PubMed ↗Publisher’s paper ↗

Citation

Hasebe, Masashi; Su, Chen-Yang; Kamido, Hisashi; Yabe, Daisuke; Yoshiji, Satoshi. (2026). GLP-1 receptor agonists and cardiovascular outcomes in Asian, Black or African American, and White populations: An updated meta-analysis including the SOUL trial.. Diabetes, obesity & metabolism. https://doi.org/10.1111/dom.70458