Description

Tirzepatide, a dual GLP‑1/GIP receptor agonist, is emerging as a disease-modifying therapy across the cardiovascular continuum, especially in obesity-related HFpEF and broader CKM disease. In the SUMMIT trial, 731 patients with obesity and HFpEF were randomized to tirzepatide or placebo; the drug reduced cardiovascular death or worsening heart-failure events by 38% and improved symptoms, exercise capacity, and health status over about two years. It also produced substantial weight loss, reduced inflammation, and was associated with favorable cardiac reverse-remodelling signals, including lower left-ventricular mass and paracardiac adipose tissue. SURPASS-CVOT further confirmed cardiovascular safety versus dulaglutide and showed a reduction in all-cause mortality. These findings support tirzepatide as more than a metabolic agent: it addresses weight, HFpEF symptoms, and hard cardiovascular outcomes. The 2026 CKM guideline reflects this shift by incorporating GLP‑1-based therapies, including dual agonists, for patients with obesity or other CKM risk factors, particularly when HFpEF is part of the clinical picture.