If you have type 2 diabetes and existing heart disease, a large new analysis found that one medication was linked to a 32 percent lower rate of major cardiovascular events over a year, compared with a common alternative pill.
The medication is tirzepatide, the active ingredient in Eli Lilly's Mounjaro (for diabetes) and Zepbound (for weight loss). The comparison drug was sitagliptin, an older diabetes pill used in the analysis as a neutral yardstick.
The study, published in The BMJ on August 5, 2026, followed 52,971 US adults aged 40 or older. All had type 2 diabetes, a body mass index of at least 25 and established atherosclerotic cardiovascular disease.
How researchers measured the benefit
Researchers looked at what doctors call MACE, short for major adverse cardiovascular events. In this analysis, MACE combined heart attack, stroke and death from any cause.
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Over one year, MACE occurred in 2.9 percent of the tirzepatide group and 4.4 percent of the sitagliptin group. That worked out to roughly one event prevented for every 70 people started on tirzepatide.
Heart attack was 33 percent less common in the tirzepatide group, and death from any cause was 45 percent less common. There was no meaningful difference in ischemic stroke. Hospital admissions for infection were also lower with tirzepatide.
Real-world data, not a randomized trial
The team used US insurance claims from May 2022 to May 2025 and applied statistical matching to make the two groups comparable. Median on-treatment follow-up was less than six months, and the results reflect people already carrying substantial cardiovascular risk.
Because this was not a randomized trial, the findings show an association rather than proof of cause and effect. A linked editorial in the same journal cautioned that the analysis does not establish a formal mortality indication or the best sequence for cardiometabolic therapy, and called for longer follow-up and head-to-head comparisons.
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Nils Krüger, MD, MPH, of Brigham and Women's Hospital and Harvard Medical School led the analysis. The authors framed tirzepatide as a complement to, not a replacement for, established cardiovascular treatments such as statins, blood pressure drugs and antiplatelet medicines.
What this means at your next appointment
Tirzepatide is already widely prescribed in the United States for type 2 diabetes and, under the brand name Zepbound, for weight loss. The new analysis is one of the largest real-world looks at its heart outcomes to date, and a dedicated randomized cardiovascular outcomes trial, SURPASS-CVOT, is still ongoing.
For anyone with type 2 diabetes and known heart disease, the practical step is to bring these findings to a prescribing physician and ask how they apply to your own situation. Do not change or stop diabetes or heart medication on your own.
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This article is made and published by Jesper Bengtson, who may have used AI in the preparation.