A 12-month effectiveness study published in The Journal of Cardiovascular Nursing reports that a structured nurse practitioner-led program was associated with GLP-1 receptor agonist use rising from 7.8% to 92.2% in patients with obesity-related heart failure with preserved ejection fraction. The work was done in humans, at a single U.S. urban academic outpatient cardiology clinic.

GLP-1 receptor agonists are the drug class that includes semaglutide and tirzepatide, originally developed for type 2 diabetes and now widely used for obesity. Heart failure with preserved ejection fraction, or HFpEF, is the form in which the heart pumps with a normal or near-normal ejection fraction but fills poorly, and the obesity-related variant is marked by systemic inflammation and reduced functional capacity.

The gap this was built to close

The authors note that these drugs improve symptoms and weight in randomized trials, but that uptake in routine cardiovascular practice is inconsistent. That is the interesting part: this is not a study about whether the drugs do something, it is a study about whether a clinic can actually get them into the patients who qualify.

The program used registry-based identification to find eligible patients, then added baseline assessment, patient education, protocolized titration and longitudinal follow-up. Each participant's own 12-month pre-enrollment period served as the comparator.

Key results

Of 156 enrolled adults, 128 completed follow-up, with a mean age of 67.4 years; 61.7% were female and 43.8% were Black. Mean weight decreased 6.2 kg, Kansas City Cardiomyopathy Questionnaire Clinical Summary Score improved 16.6 points, and 6-minute walk distance rose 48.3 meters, all at P < .001.

Heart failure hospitalization fell from 18.2% to 4.7%. Gastrointestinal symptoms were the most common adverse effect and 4.7% of participants discontinued for intolerance.

Limitations

This was a single-center, pre-post design with no separate control group: each patient was compared against their own prior year, which cannot rule out secular trends or regression to the mean. Roughly 18% did not complete follow-up, and the authors frame their findings as association rather than causation.

Who delivers the care

The conclusion is about a care model, not a molecule, and the figure worth watching is the 87.5% who reached target dose. Whether that persistence holds outside one academic clinic, with different staffing and different payers, is the question this design cannot answer.