Heart Health: The Impact of GLP-1 Medications and Morning Exercise
Recent research highlights the crucial role of consistent medication adherence for individuals with type 2 diabetes and the potential benefits of incorporating morning exercise into a routine. Studies demonstrate that interrupting GLP-1 medications can quickly diminish their heart-protective effects, while morning physical activity is linked to a reduced risk of cardiovascular disease and improved metabolic health.
Heart Risk Rebounds After Stopping GLP-1 Drugs
GLP-1 medications, used in the treatment of type 2 diabetes, have been shown to reduce the risk of adverse cardiac events. However, a new analysis reveals that even short interruptions in treatment—as little as a few months—may increase the risk of heart attack, stroke, or death.
“Discontinuing GLP-1 medications can quickly erode and potentially reverse the cardiovascular protection these medications provide,” stated Dr. Ziyad Al-Aly of the Veterans Affairs Saint Louis Health Care System in Missouri. “Months of downtime can undo years of progress.” BMJ Medicine
Researchers analyzed data from over 333,000 adults with type 2 diabetes treated with GLP-1 drugs or sulfonylureas, utilizing three years of medical records from a U.S. VA database.
GLP-1 drugs commonly used include Ozempic and Victoza (Novo Nordisk NOVOb.CO) and Trulicity and Mounjaro (Eli Lilly LLY.N).
The study found that patients who continued taking GLP-1 medications experienced an 18% reduction in cardiovascular risk compared to those taking sulfonylureas. However, stopping treatment for just six months erased much of this protection, increasing risk by 4% compared to continued treatment. After two years of discontinuation, cardiovascular risk increased by 22% compared to ongoing use.
“Resuming treatment restored some cardioprotective effects, but only partially,” added Dr. Al-Aly. Factors contributing to treatment interruptions include side effects, medication shortages, and cost.
“When they stop, it’s not just the weight that comes back. They experience a resurgence of inflammation, blood pressure and cholesterol,” Dr. Al-Aly explained. “Weight regain is visible, but metabolic reversal is not. We consider this to be a form of metabolic whiplash, which appears to be detrimental to heart health.”
Morning Exercise Linked to Lower Cardiometabolic Risk
While any exercise is beneficial, research suggests that morning physical activity may offer additional advantages. A study tracking 14,000 U.S. Volunteers using Fitbit data revealed that those who regularly exercised in the morning were 31% less likely to develop coronary heart disease compared to those who exercised later in the day.
Morning exercisers also demonstrated an 18% lower likelihood of high blood pressure, a 21% reduction in high cholesterol, a 30% decrease in type 2 diabetes risk, and a 35% lower risk of obesity, irrespective of total daily physical activity levels.
The study indicated that physical activity between 7 and 8 a.m. Was associated with the lowest risks of coronary heart disease.
Researchers plan to present these findings at the American College of Cardiology annual meeting. American College of Cardiology
The data, representing the first large-scale study assessing exercise timing based on long-term wearable device use, cannot definitively establish a causal relationship between timing and cardiometabolic health. Biological factors like hormones, sleep, and genetics, as well as behavioral and psychological factors, may also play a role.
“In the past, researchers have mostly been interested in the amount of physical activity to do, the number of minutes or the intensity of physical activity,” explained Prem Patel, a medical student at the University of Massachusetts Chan School of Medicine. “Now that one in three Americans owns a wearable device, we have the ability to look at exercise at the minute-by-minute level, which opens many doors in terms of new analytics.”