Description
A drug class cardiologists inherited
GLP-1 receptor agonists were diabetes drugs, then obesity drugs, and are now cardiovascular drugs with outcome data cardiologists cannot ignore. Most of us are prescribing or endorsing them without ever having been taught the class properly, and the monitoring has not caught up with the uptake.
These 392 pages address both halves.
The benefit, stated properly
Cardiovascular outcome data across the trial programme, including the effect in patients without diabetes, and the emerging heart failure with preserved ejection fraction signal. Where the benefit appears independent of weight loss, and where it does not.
The part that is under-monitored
Rapid weight reduction is not selectively fat loss. Lean mass — including cardiac muscle — is lost alongside it, which matters particularly in older and frailer patients who are also those most likely to be prescribed these agents for cardiovascular indications. Reduced intake produces micronutrient deficiencies with direct cardiac consequences: thiamine, magnesium, potassium, iron, vitamin D and B12. The volume sets out what to monitor and at what interval, which no guideline currently specifies clearly.
Practical prescribing
Titration and gastrointestinal tolerance. Interaction with heart failure therapy. What happens on discontinuation. Which patients should be having resistance exercise and protein intake advice alongside the drug — a conversation that is currently rare and should not be.
Placement
Prevention track, and recommended across all tracks given how widely the class is now used.
PDF, lifetime access, via CardiologyBooks.com.
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