Real-World Study Confirms Semaglutide Helps Heart Failure Patients With Obesity and Diabetes | Research

The takeaway

Once-weekly semaglutide 1.0 mg improved health status and reduced body weight in real-world patients with HFpEF, obesity, and type 2 diabetes.

Real-world confirmation
Prospective study validates that semaglutide benefits for HFpEF seen in clinical trials translate to everyday patients

What the researchers found

Once-weekly semaglutide 1.0 mg improved health status and reduced body weight in real-world patients with HFpEF, obesity, and type 2 diabetes versus controls.

Why it matters

Real-world evidence confirms that the benefits seen in controlled clinical trials also apply to typical patients seen in everyday medical practice.

The numbers in context

203 matched patients per group. Primary outcome (>= 5-point KCCQ improvement): 60.6% semaglutide vs 17.7% control (OR 3.99). Semaglutide 1 mg weekly. 24-month follow-up.

How the study worked

Prospective, real-world comparative study of patients with HFpEF, obesity, and T2D treated with semaglutide 1.0 mg weekly versus controls not on GLP-1 RAs.

Who was studied

Obese adults with HFpEF and T2D

What this study cannot tell us

Non-randomized design — patients choosing semaglutide may differ from controls in unmeasured ways. Single semaglutide dose studied (1.0 mg, not the higher 2.4 mg obesity dose).

How to read the evidence

Prospective observational study — stronger than retrospective data but weaker than randomized trials. Provides important real-world validation.

When this study was published

Published in 2025, providing real-world evidence complementing recent clinical trial results.

The bigger picture

This adds to the growing case for using GLP-1 drugs to treat the metabolic-cardiac overlap that is increasingly common in aging, obese populations.

Questions still open

Would higher semaglutide doses (2.4 mg) provide even greater HFpEF benefits?
How do these real-world results compare to the STEP-HFpEF trial outcomes?

Common questions

Does semaglutide help with heart failure in real patients?

Yes, this real-world study confirms that semaglutide improves health status and reduces weight in everyday patients with heart failure, obesity, and diabetes — not just in carefully selected clinical trial participants.

Is the 1.0 mg dose used for heart failure the same as for weight loss?

No. The 1.0 mg dose is the standard diabetes dose (Ozempic). The higher 2.4 mg dose (Wegovy) is used for weight loss. This study used the lower dose and still showed cardiac and weight benefits.

Read the original research

Efficacy of once-weekly semaglutide in patients with heart failure with preserved ejection fraction, obesity and type 2 diabetes.

Medicina clinica, 165(3), 107019

View on PubMed ↗Publisher’s paper ↗

Citation

Pérez-Velasco, Miguel A; Bernal-López, Maria-Rosa; Trenas, Alicia; Ricci, Michele; López-Carmona, María-Dolores; García de Lucas, María-Dolores; Gómez-Huelgas, Ricardo; Pérez-Belmonte, Luis M. (2025). Efficacy of once-weekly semaglutide in patients with heart failure with preserved ejection fraction, obesity and type 2 diabetes.. Medicina clinica, 165(3), 107019. https://doi.org/10.1016/j.medcli.2025.107019