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Semaglutide for Symptom Management in HFpEF and Related Metabolic Phenotypes Kimmy Nguyen Jul 24, 2025 5 min read Updated: Sep 13, 2025 Written by Alex Flores-Xie, PharmD Candidate 2026 and Adenike Atanda-Oshikoya, PharmD, BCACP, CDCES, CTTS HFpEF: A Growing Challenge Heart Failure (HF) is a heterogenous syndrome defined by structural or functional cardiac abnormalities impairing the hearts ability to meet metabolic demands.(1,2) HF is classified by left-ventricular ejection fraction (LVEF) into: HF with reduced EF (HFrEF, LVEF 40%).(1) With over 80% of patients with HFpEF being overweight or obese, this phenotype accounts for most HF cases in the United States and continues to rise in prevalence.(3) Obesity worsens clinical outcomes via cardiac adverse remodeling.(4) Excess adiposity contributes to HFpEF progression through increased leptin levels, reduced natriuretic peptides, and activation of the renin-angiotensin-aldosterone system (RAAS), leading to systemic inflammation, cardiac fibrosis, and arterial stiffness.(3) Patients with HFpEF, obesity, and diabetes experience greater adverse hemodynamics, worse functional capacity, and quality of life.(4) HFpEF, accounts for up to 50% of HF hospitalizations.(2) Hospitalized patients are often older females with obesity, type 2 diabetes mellitus (T2DM), hypertension, atrial fibrillation, and chronic kidney disease
Contact your GP, trial team, or call NHS 111 promptly if you experience: Diarrhoea that is severe, bloody, or persists for more than 4872 hours without improvement Signs of dehydration, including dizziness, reduced urine output, dry mouth, or confusion Significant abdominal pain, particularly if severe or radiating to the back this may rarely indicate pancreatitis, a recognised risk associated with GLP-1-based therapies Pain in the upper right abdomen, fever, or yellowing of the skin or eyes (jaundice) these may suggest gallbladder disease, another recognised complication of this drug class [23] [24] Severe constipation, abdominal distension, or inability to pass wind or stools these may rarely indicate intestinal obstruction or ileus, for which the MHRA and EMA have issued safety communications in relation to GLP-1 receptor agonists [11] [12] Unexplained weight loss beyond what is expected from the treatment Vomiting that prevents adequate fluid or food intake Call 999 or go to your nearest A&E immediately if symptoms are severe, rapidly worsening, or you are unable to keep any fluids down
Introductory pricing starts at $99.99 per month for semaglutide and $132.99 for tirzepatide with a 3-month commitment
The exclusion criteria were BMI 30, HIV-positive status, irregular menstrual cycle, pregnancy or breastfeeding in the past 6 months, COC/hormone use in the past 4 years (controls), use of COC formulations other than DRSP/EE, use of COC for less than 3 months, self-reported indications of diabetes, liver or kidney disease, asthma, other chronic diseases, chronic medication use, and smoking more than 5 cigarettes/day
The data tells a different story
