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GLP-1 RAs reduce major cardiovascular events by 14% through multiple mechanisms beyond glucose control, including anti-inflammatory effects and blood pressure reduction SELECT trial proved cardiovascular benefits extend to non-diabetic patients with obesity, showing 20% MACE reduction in those without diabetes Semaglutide, liraglutide, and dulaglutide demonstrate the strongest cardiovascular protection, with proven benefits in large outcome trials These agents provide specific benefits for heart failure with preserved ejection fraction and kidney protection, reducing albuminuria by 24% Current guidelines strongly recommend GLP-1 RAs for patients with established cardiovascular disease, regardless of diabetes status or HbA1c levels The evidence positions GLP-1 receptor agonists as fundamental cardiovascular medications rather than merely diabetes drugs with heart benefits