Novo Nordisk brings oral semaglutide heart data to ESC 2026, framing organ protection over weight loss

Novo Nordisk brought cardiovascular analyses of oral semaglutide to the European Society of Cardiology Congress in Munich, held Aug. 28–31, 2026, and framed the program around organ protection rather than glucose or weight control alone ^[1][2].

The company's oral semaglutide presentation is scheduled for Sunday, Aug. 30, from 13:15 to 14:00 CEST. The session is titled "Cardiovascular outcomes by baseline blood pressure control status in persons with type 2 diabetes at high cardiovascular risk treated with oral semaglutide," with N. Poulter as lead author and a co-author list that includes S. E. Inzucchi, N. Marx, J. E. Deanfield and D. K. McGuire ^[1]. The congress agenda lists the materials as "coming soon," so the numerical results have not been posted ^[1].

The analysis builds on SOUL, a trial that showed cardiovascular benefit with oral semaglutide in people with type 2 diabetes and established cardiovascular or chronic kidney disease ^[2]. Two earlier semaglutide trials reached related conclusions in different populations: SUSTAIN 6 showed cardiovascular benefit with injectable semaglutide in type 2 diabetes, and SELECT extended the evidence to people with overweight or obesity and established cardiovascular disease who did not have diabetes ^[2].

Henrik Jarlov, vice president of Global Medical Affairs, Diabetes and Cardiovascular at Novo Nordisk, told Korea Biomedical Review at the congress that the evidence across SUSTAIN 6, SELECT and SOUL supports cardiovascular risk reduction as a reproducible effect of semaglutide across oral and injectable formulations ^[2]. He also cautioned against extending that conclusion to every GLP-1-based medicine, saying the drugs differ in molecular structure, half-life, receptor engagement and their effects on glucose and body weight, and that some earlier-generation therapies failed to show cardiovascular benefit ^[2].

How much of the benefit comes from weight loss is a central question at the meeting. Jarlov said mediation analyses suggest weight loss accounts for only part — and in some analyses potentially very little — of the cardiovascular benefit ^[2]. In SELECT, he said, cardiovascular risk reduction began to emerge relatively early in treatment, before patients had reached the full weight loss eventually achieved in the trial ^[2]. He pointed to the STRIDE study in peripheral arterial disease as evidence of vascular effects beyond weight reduction, and to the STEP-HFpEF program, where semaglutide improved symptoms and physical function in patients with obesity-related heart failure with preserved ejection fraction. In that program, changes in NT-proBNP did not appear to correlate directly with the degree of weight change ^[2].

Cardiovascular inflammation is the other thread. A Saturday symposium, "Cardiovascular inflammation: The silent killer on trial," ran from 10:00 to 10:45 CEST with Paul M. Ridker, Nikolaus Marx and Vijay Kunadian ^[1]. Novo Nordisk's Phase 3 ZEUS trial of ziltivekimab, an interleukin-6 ligand inhibitor, failed to reduce major adverse cardiovascular events in patients with established atherosclerotic cardiovascular disease, chronic kidney disease and systemic inflammation, although it substantially reduced inflammatory markers including high-sensitivity C-reactive protein ^[2]. Two other interleukin-6 programs, ARTEMIS in acute myocardial infarction and HERMES in HFpEF, are continuing ^[2].

Why it matters for patients

People taking or considering oral semaglutide may hear that the drug protects the heart, but who benefits most is still being sorted out. The Munich analysis asks whether cardiovascular outcomes differ depending on how well a patient's blood pressure was controlled at the start of treatment — a question with practical relevance for patients who also take blood pressure medication ^[1].

The mediation discussion matters because it challenges a simple rule of thumb: that the most weight lost equals the most cardiovascular protection. Jarlov said treatment selection may increasingly depend on a patient's main clinical need, whether that is weight reduction, organ protection, tolerability, preservation of function or convenience. He added that the greatest possible weight loss is not necessarily the best outcome for every patient, particularly older or frail patients ^[2].

The inflammation work is separate from semaglutide. ZEUS did not meet its goal, and no results from ARTEMIS or HERMES have been reported ^[2].

What happens next

The oral semaglutide blood pressure analysis is scheduled for Sunday, Aug. 30, 13:15–14:00 CEST, with materials marked as coming soon ^[1]. ESC 2026 closes Aug. 31 ^[1]. Novo Nordisk has not disclosed when ARTEMIS or HERMES will report results ^[2]. Jarlov also said direct comparisons of oral and injectable GLP-1 formulations in patient-reported outcomes remain limited, and that more real-world evidence will be important ^[2].