Biohacking My Heart

Semaglutide: an outcome trial in a defined population​

SELECT enrolled adults aged 45 or older with established cardiovascular disease and overweight or obesity, without diabetes; major cardiovascular events occurred in 6.5% of the semaglutide group versus 8.0% of the placebo group (American College of Cardiology: SELECT trial). The finding applies to the studied population and regimen, not every healthy person hoping to prevent a first event.

FDA approved Wegovy for cardiovascular-risk reduction in adults with established cardiovascular disease and overweight or obesity, alongside diet and physical activity (FDA: semaglutide cardiovascular-risk indication (2024)). Eligibility, contraindications, side effects and the current label require an individual clinical review.

Tirzepatide: encouraging evidence in obesity-related HFpEF​

SUMMIT studied 731 people with obesity and heart failure with preserved ejection fraction; the composite of cardiovascular death or worsening heart failure occurred in 9.9% with tirzepatide versus 15.3% with placebo (American College of Cardiology: SUMMIT trial (2024)). The difference was driven primarily by fewer worsening-heart-failure events, not proof of reduced cardiovascular death on its own.

Symptoms, physical function and weight also improved in the trial, but this is a specific heart-failure population rather than a general prevention study (American College of Cardiology: SUMMIT trial (2024)). A trial result is not permission to infer every possible current label indication.

Telmisartan: steady blood-pressure control, with a second pathway worth understanding​

For someone with high blood pressure, telmisartan offers a practical benefit: steady, once-daily blood-pressure control that lasts through a full 24-hour dosing interval (telmisartan prescribing information). It is an angiotensin II receptor blocker (ARB) that blocks the angiotensin II type 1 receptor (AT1), helping blood vessels relax and reducing the signal that tells the body to retain salt and water (telmisartan prescribing information).

That blood-pressure control matters for long-term health: lowering high blood pressure helps reduce the risk of stroke and heart attack (telmisartan prescribing information). Telmisartan also has a specific cardiovascular-risk-reduction indication for certain high-risk adults aged 55 or older who cannot take angiotensin-converting enzyme (ACE) inhibitors (telmisartan prescribing information).

A promising connection to metabolic health makes telmisartan especially interesting to researchers. Laboratory studies show that it partly activates peroxisome proliferator-activated receptor gamma (PPAR-gamma, or PPARγ), a receptor inside cells that helps regulate how the body handles glucose and fat (PPARγ structural study (2012)). Think of it as a cellular control switch for metabolism, distinct from the androgen receptor that responds to testosterone.

A review of randomized trials found better measures of insulin resistance with telmisartan than with other blood-pressure medicines in people with hypertension (randomized-trial meta-analysis (2014)). That is an encouraging reason to discuss blood pressure and metabolic health together. Results vary: a trial in people without hypertension or diabetes found no improvement in insulin sensitivity (metabolic trial (2010)). These studies do not establish extra heart-attack protection through PPARγ or telmisartan as a stand-alone weight-loss or diabetes treatment; its clearest established benefit remains blood-pressure control (randomized-trial meta-analysis (2014); telmisartan prescribing information).

Muscle and exercise research is another promising area: telmisartan improved running endurance in mice through muscle-energy pathways (mouse endurance study). A small 2025 study of 13 people with peripheral artery disease found larger muscle fibers and lower myostatin gene expression with telmisartan plus supervised exercise compared with exercise plus placebo (human muscle study). These early findings support further research, not a proven performance-enhancing effect in healthy athletes; the larger 114-person trial did not show improved walking performance with telmisartan (TELEX randomized trial).

An early clue about hormone metabolism has also drawn interest. A small, uncontrolled report followed four women with high blood pressure and polycystic ovary syndrome (PCOS) and found lower androgen levels during telmisartan treatment, raising questions about possible effects on ovarian hormone production and metabolism (four-patient PCOS case series). That finding invites further research, but four uncontrolled cases cannot establish cause and effect (four-patient PCOS case series). The study did not measure androgen-receptor expression or binding, so it does not show receptor upregulation or justify using telmisartan as a hormone-management treatment (four-patient PCOS case series).

A personalized plan helps put these benefits to work safely. Your licensed medical provider can review whether telmisartan fits your blood-pressure needs and arrange monitoring of kidney function and potassium, with attention to other medicines, supplements and potassium-containing salt substitutes (telmisartan prescribing information). Telmisartan can harm a developing fetus and should not be used during pregnancy; discuss a safer option before trying to conceive (telmisartan prescribing information). If you already take a heart-failure medicine, make any treatment change with your prescriber rather than substituting telmisartan yourself.

Angiotensin-(1–7): a research pathway, not an established prevention plan​

Angiotensin-(1–7) has interesting vascular and remodeling effects in experimental models, while human studies have been limited and sometimes conflicting (Angiotensin-(1–7): translational cardiovascular research (2019)). Changes in local blood flow are not equivalent to evidence that a commercially marketed injection prevents heart attacks.

Formulation, short half-life and uncertain clinical safety remain important research issues (Angiotensin-(1–7): translational cardiovascular research (2019)). This article does not recommend sourcing or using an investigational peptide outside an appropriate research or clinical pathway.

Collagen peptides: do not confuse markers with events​

A small open-label collagen-tripeptide study reported changes in vascular and lipid-related markers, but lacked a randomized control group (Collagen tripeptide: uncontrolled vascular-marker study (2017)). It did not demonstrate prevention of heart attack, stroke or cardiovascular death.

Dietary supplements should not displace proven risk-factor care. Even an appealing biological mechanism needs an appropriate human outcome trial before it becomes a prevention promise.