If you live with pulmonary hypertension (PH), managing your health may already feel like a balancing act. Now, with the growing popularity of glucagon-like peptide-1 (GLP-1) receptor agonists like semaglutide to treat type 2 diabetes and promote weight loss, you might wonder if these drugs are safe for someone with PH.

This article will break down what GLP-1 drugs are, how they work, and what current research says about their safety for individuals with PH.

What Are GLP-1 Receptor Agonists?

GLP-1 drugs are a class of medications commonly used to treat type 2 diabetes and obesity. They mimic the GLP-1 hormone in your body, which is naturally released after eating.

GLP-1 plays several important roles: It helps control blood glucose by stimulating insulin release and slowing down how quickly food leaves your stomach. In addition, GLP-1 drugs help with weight loss by reducing appetite. Some well-known drugs in this class include:

• Dulaglutide (Trulicity)
• Exenatide (Byetta, Bydureon)
• Liraglutide (Victoza)
• Semaglutide (Ozempic, Wegovy, Rybelsus)

These medications are considered safe and effective for improving blood glucose (sugar) control in people with type 2 diabetes. They’ve also been found to promote weight loss, which is particularly beneficial for individuals with obesity. However, with all medications, it’s important to understand the potential risks — especially for those managing conditions like PH.

What Is Pulmonary Hypertension?

PH is a type of high blood pressure that affects the arteries in your lungs and the right side of your heart. In one form of PH called pulmonary arterial hypertension, the arteries that carry blood from your heart to your lungs become narrow or blocked, making it harder for blood to flow through them. This blockage increases the pressure in these arteries, leading to symptoms like shortness of breath, fatigue, dizziness, and chest pain.

Although anyone can develop PH, certain factors increase your risk. These include:

• Heart disease
• Lung disease — For example, chronic obstructive pulmonary disease (COPD) or interstitial lung disease, which causes lung scarring
• Blood clots in the lungs
• Autoimmune diseases — Such as scleroderma or lupus
• Genetics

The condition can get worse over time, and for many people, managing PH involves medications that relax blood vessels, improve heart function, remove excess fluid, or lower blood pressure in the lungs, as well as oxygen therapy.

Could GLP-1 Drugs Affect Pulmonary Hypertension?

As the use of GLP-1 receptor agonists increases, people with PH may wonder whether these drugs might affect their condition. So, can drugs like Ozempic cause pulmonary hypertension? At this time, research does not suggest that GLP-1 drugs directly cause the condition. Studies from University of Chicago Medicine indicate that GLP-1 drugs may have some protective effects on the cardiovascular system.

A 2023 review found that GLP-1 receptor agonists are generally well-tolerated, with potential cardiovascular benefits, especially for people with diabetes and obesity who are at risk of heart disease.

What Does the Research Say About GLP-1 Drugs for People With PH?

Although there’s no conclusive evidence that GLP-1 drugs cause PH, the relationship between diabetes medications and PH is still an area of ongoing research.

Some early studies have shown mixed results about the safety of certain diabetes medications in people with cardiovascular conditions, but GLP-1 drugs seem to stand out for their potential heart-protective benefits. In a 2020 study, GLP-1 drugs were linked to reduced cardiovascular events in people with type 2 diabetes.

That said, remember everyone is different. People with PH often have underlying metabolic conditions, making it important to closely watch how new medications might affect their current treatments.

Key Considerations for People With PH Considering GLP-1 Drugs

If you have PH and are considering taking a GLP-1 receptor agonist, it’s important to have an open conversation with your health care provider. Here are some key factors to discuss.

Your Current Medications

PH often requires a combination of treatments, including medications like vasodilators, blood thinners, and diuretics. Adding a GLP-1 drug to the mix could potentially interact with your current medications, so talk with your doctor about any risks.

Monitoring for Side Effects

If you and your health care provider decide to proceed with a GLP-1 drug, close monitoring is crucial. Some common adverse events of GLP-1 receptor agonists include nausea, vomiting, and diarrhea. Rare, more serious complications include pancreatitis (severe inflammation of the pancreas), changes in heart function, or breathing problems.

If you’re living with PH, be especially vigilant for symptoms like worsening shortness of breath or chest pain, as these could signal a complication.

Consider Alternative Treatment

For people with PH who are concerned about the potential risks of GLP-1 drugs, there are alternative antidiabetic treatments available for managing diabetes and weight loss. Your health care provider may suggest other classes of diabetes medications. These may include sodium-glucose cotransporter 2 (SGLT2) inhibitors, which help remove excess sugar through urine, or dipeptidyl peptidase 4 (DPP-4) inhibitors, which help regulate insulin levels. Additionally, lifestyle changes, including changes in diet and regular exercise, can help support blood sugar control and overall heart and lung health.

Discuss Weight Management Goals

For people with PH, weight management can play a role in improving both heart and lung function. Obesity has been shown to worsen PH symptoms in some cases, as excess weight can put additional strain on the heart. Because GLP-1 drugs are effective in promoting weight loss, they could be a valuable tool for some people.

However, the decision to use these medications should be made in the context of your overall health, including the status of your PH. Weight loss through these drugs may help ease pressure on the heart and lungs, but this must be carefully managed with the guidance of a health care provider.

Weighing the Benefits and Risks

GLP-1 receptor agonists offer promising benefits for people managing type 2 diabetes and obesity. Although current research does not indicate that GLP-1 drugs cause PH, individuals with the condition should be careful when considering these medications. Given the complexity of PH and its potential impact on the heart and lungs, it’s essential to work closely with your health care provider to weigh the benefits and risks before starting any new treatment.

Keep an open line of communication with your doctor. That way, you can make informed decisions about your health and find the treatment plan that works best for you. Whether you choose a GLP-1 or explore other treatments, focusing on your lung health is key to living fully and staying as healthy as possible.

Talk With Others Who Understand

On myPHteam, the social network for people with pulmonary hypertension and their loved ones, more than 55,000 members come together to ask questions, give advice, and share their stories with others who understand life with pulmonary hypertension.

Are you living with pulmonary hypertension and considering a GLP-1 drug? Share your experience in the comments below, or start a conversation by posting on your Activities page.