Tirzepatide, a novel dual receptor agonist (GLP-1/GIP), has garnered significant attention in recent years for its role in the treatment of diabetes. However, its potential in cardiovascular and renal diseases is gradually emerging. Recent studies show that tirzepatide demonstrates remarkable efficacy in patients with heart failure with preserved ejection fraction (HFpEF) combined with obesity and chronic kidney disease (CKD). The SUMMIT clinical trial revealed that patients receiving tirzepatide had a 38% reduction in the risk of cardiovascular death or heart failure worsening within 52 weeks, while renal function indicators such as eGFR significantly improved. This discovery offers a new therapeutic approach for patients with complex metabolic disorders.
In the cardiovascular field, tirzepatide's mechanism of action goes beyond metabolic regulation. By activating both GLP-1 and GIP receptors, it reduces the volume of adipocytes, thereby alleviating the mechanical pressure of fat tissue on the heart and improving myocardial energy metabolism and anti-ischemic capacity. For HFpEF patients, obesity and chronic inflammation are key contributors, and tirzepatide’s dual-receptor activation effectively suppresses inflammatory cytokine release and reduces myocardial fibrosis, thereby delaying the deterioration of cardiac function. Additionally, it improves patient-reported quality of life scores (such as KCCQ-CSS) and exercise capacity.
Tirzepatide also shows promising effects in renal protection. CKD is often accompanied by metabolic disturbances and low-grade inflammation. The drug acts through dual pathways: improving glomerular hemodynamics to reduce proteinuria, and directly inhibiting the process of renal fibrosis. In the SUMMIT trial, tirzepatide significantly increased eGFR levels based on cystatin C and reduced albuminuria regardless of whether the patients had CKD, indicating comprehensive renal protection. This finding paves a new path for treating diabetic nephropathy and other chronic kidney diseases.
Even more noteworthy is tirzepatide’s unique value in patients with the “triad” of obesity, HFpEF, and CKD—a group with typically poor prognosis. Tirzepatide improves body composition (reducing fat accumulation and enhancing muscle metabolic efficiency) and modulates inflammatory pathways, thereby offering coordinated protection across multiple organs. As indications for tirzepatide continue to expand, it is poised to become a cornerstone therapy in the management of metabolic diseases with comorbidities.
Post time: Jul-21-2025