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ObesityDecember 2023Summary reviewed May 2026

Semaglutide Injection Cut Heart Attack and Stroke Risk 20% in Overweight Adults

SELECT tested semaglutide, a once-weekly injection, in 17,604 adults with overweight or obesity and existing heart disease but no diabetes. After more than three years on average, semaglutide cut major cardiovascular events compared with placebo, separate from any diabetes benefit.

What the trial was testing

The SELECT enrolled 17,604 patients with obesity. The study was sponsored by Novo Nordisk and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

20% lower risk of heart attack, stroke, or cardiovascular death.

New England Journal of Medicine · 2023 · NCT03574597

These findings — that of heart attack, stroke, or cardiovascular death in overweight adults with heart disease — were published in the New England Journal of Medicine and represent the headline result of the study.

Researchers tracked outcomes across 17,604 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with obesity, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Semaglutide (Wegovy) is FDA-approved both for chronic weight management and to lower the risk of heart attack and stroke in adults with overweight or obesity and existing heart disease. The most common side effects are nausea and stomach upset that ease over time. Ask your doctor or cardiologist whether you qualify.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.