Glucagon-like peptide 1 receptor agonists in cardiovascular-kidney-metabolic syndrome: a review

Abstract

With the rising global prevalence of obesity and type 2 diabetes, metabolic disorders have become major drivers of cardiovascular morbidity and mortality worldwide. Cardiovascular-kidney-metabolic (CKM) syndrome encompasses obesity, type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and cardiovascular disease (CVD), all of which share common pathophysiological pathways. Glucagon-like peptide-1 receptor agonists (GLP-1RAs), a novel class of antihyperglycemic agents, have demonstrated pleiotropic effects—including weight reduction, blood pressure lowering, albuminuria reduction, decreased major adverse cardiovascular events (MACE), and slowed progression of renal dysfunction. These benefits position GLP-1RAs as a potential cornerstone therapy for CKM syndrome. This review synthesizes recent advances in GLP-1RA research within the CKM framework, explores their underlying mechanisms, and offers insights to refine diagnostic and therapeutic strategies for cardiometabolic diseases.