From the Guidelines
Semaglutide can cause an increase in heart rate, typically by ~5 bpm, as noted in the most recent and highest quality study 1. This effect is considered a class effect of GLP-1 receptor agonists and is generally not clinically significant for most patients. The heart rate increase usually occurs within the first few weeks of treatment and tends to persist while on the medication. For most people with normal cardiovascular health, this modest increase poses minimal risk. However, patients with pre-existing cardiovascular conditions, especially those with tachycardia or certain arrhythmias, should be monitored more closely. The mechanism behind this heart rate increase is thought to be related to direct effects on the sinoatrial node and autonomic nervous system regulation. If a patient experiences palpitations, dizziness, or unusual fatigue while taking semaglutide, they should contact their healthcare provider. Regular monitoring of heart rate and blood pressure is recommended during the initial titration period of semaglutide treatment, particularly for those with cardiovascular risk factors. Some key points to consider when prescribing semaglutide include:
- Monitoring for signs of cardiovascular disease
- Adjusting the dose based on patient response and tolerability
- Considering alternative treatments for patients with a history of cardiovascular disease or arrhythmias
- Educating patients on the potential risks and benefits of semaglutide treatment. It's also important to note that semaglutide has been shown to have cardiovascular benefits, including reducing the risk of major adverse cardiovascular events, as demonstrated in studies such as SUSTAIN-6 1. Overall, the benefits of semaglutide treatment, including its cardiovascular benefits, should be weighed against the potential risks, including the increase in heart rate, when making treatment decisions.
From the Research
Semaglutide and Heart Rate
- There is no direct information available on the effect of semaglutide on heart rate in the provided studies 2, 3, 4, 5, 6.
- However, the studies do discuss the cardiovascular benefits of semaglutide, including its ability to reduce major adverse cardiovascular events (MACE) and improve cardiovascular risk factors in patients with type 2 diabetes 3, 4, 5.
- One study found that oral semaglutide significantly decreased systolic blood pressure after 6 months of treatment, which may have an indirect effect on heart rate 5.
- Another study found that semaglutide reduced the risk of major adverse cardiovascular events, including death from cardiovascular causes, nonfatal myocardial infarction, or nonfatal stroke, but did not specifically mention heart rate 4.
- Overall, while there is no direct evidence on the effect of semaglutide on heart rate, the available studies suggest that semaglutide may have beneficial effects on cardiovascular health, which could potentially impact heart rate 2, 3, 4, 5, 6.