Do GLP-1 Drugs Like Ozempic and Mounjaro Lower Stroke Risk? The Evidence

Do Ozempic, Wegovy and Mounjaro lower your risk of stroke? For people with type 2 diabetes, the trial evidence points to a modest reduction. Meta-analyses of the large cardiovascular trials found about 12–16% fewer strokes, mostly ischemic (clot) strokes.^[1][2] The effect is small enough that one large 2025 meta-analysis found no significant difference.^[3] For people with obesity but no diabetes, there is no proof yet: trials have not shown a significant effect on stroke, though semaglutide does lower heart attacks, strokes and cardiovascular deaths counted together.^[4][5][9] This article covers what the trials and the newest 2026 studies show, and who is most likely to benefit.

The short answer

• Type 2 diabetes: probably yes, modestly. Across 13 randomized trials (65,878 people), GLP-1 drugs lowered the odds of stroke by 16% and ischemic stroke by 26%, with no effect on bleeding (hemorrhagic) strokes.^[1]
• Not every analysis agrees. A 2025 meta-analysis of 21 trials (99,599 people) confirmed fewer deaths and cardiovascular events overall, but found “no differences in stroke.”^[3]
• Obesity without diabetes: not shown yet. A meta-analysis of 29 trials found no significant difference in stroke, and a 2026 review said recent trials “have not shown a significant effect on stroke incidence” in people without diabetes.^[4][5]
• The 2026 observational studies are more striking, with up to about half the stroke risk in Swedish data. Observational studies tend to overestimate benefit, so treat these as a signal, not a measured effect.^[7]

What the randomized trials show in type 2 diabetes

The best evidence comes from the large cardiovascular outcome trials that compared GLP-1 drugs with placebo in people with type 2 diabetes. Three meta-analyses have pooled them:

The two analyses that focused on stroke found a reduction of roughly 12–16%, driven by ischemic strokes, which are caused by a blocked artery.^[1][2] In the Swedish cohort described below, 2,734 of 3,162 strokes were ischemic.^[7] The JACC analysis was broader, pooling 21 trials of eight different GLP-1 drugs, and found clear reductions in deaths, heart attacks and heart failure but no significant difference in stroke.^[3] The honest reading: any stroke benefit in diabetes is real but modest, and smaller than the benefit for heart attacks.

Two findings suggest who benefits most. People who had already had a stroke saw the biggest reduction (HR 0.73, number needed to treat 54), and the stroke benefit “strengthened over time,” reaching HR 0.80 after 24 months.^[2] In other words, the effect seems to build with long-term use.

What about people without diabetes?

This is the question most people taking Wegovy or Zepbound for weight loss are asking, and the answer is less clear. The SELECT trial gave semaglutide 2.4 mg or placebo to 17,604 adults with obesity or overweight and heart disease but no diabetes. Semaglutide cut the combined rate of cardiovascular death, nonfatal heart attack and nonfatal stroke from 8.0% to 6.5% (HR 0.80).^[9] For the full results, see our SELECT trial review.

When strokes are counted on their own, though, the trial evidence in people without diabetes does not show a clear reduction. A meta-analysis of 29 randomized trials in people with obesity and no diabetes found GLP-1-based drugs reduced heart attacks (relative risk 0.72), major cardiovascular events and deaths, but “no significant differences were observed in cardiovascular death or stroke.”^[4] A 2026 Stroke review reached the same conclusion: recent trials “have not shown a significant effect on stroke incidence or neurological recovery in patients without diabetes.”^[5] That doesn't mean there is no effect, only that the trials so far haven't been able to show one.

The 2026 studies

After a stroke: liraglutide and insulin resistance

The LAMP trial randomized people with type 2 diabetes and a minor stroke or high-risk TIA (a “mini-stroke”) to liraglutide plus standard care, or standard care alone. A 2026 analysis of 510 participants found the benefit depended on insulin resistance. In people with a HOMA-IR of 2.5 or more, recurrent stroke over 3 months fell from 18.1% to 5.8% (number needed to treat 8). Those with lower insulin resistance saw no significant benefit.^[6] This is a post hoc subgroup of an open-label trial with only 3 months of follow-up, so it generates a hypothesis rather than proving one.

Sweden: a nationwide cohort

In 171,917 people with type 2 diabetes in the Swedish National Diabetes Register, GLP-1 use was associated with less than half the risk of ischemic stroke (HR 0.46) and about half the risk of any stroke (HR 0.51), with no clear association for hemorrhagic stroke. SGLT2 inhibitors and DPP-4 inhibitors showed no clear association. The authors noted that the direction matched the trial meta-analyses.^[7] The size of the effect is much larger than in the trials, a common pattern in observational data.

Atrial fibrillation: tirzepatide vs other GLP-1s

People with atrial fibrillation are at high stroke risk even on blood thinners. In 14,118 matched pairs with atrial fibrillation and type 2 diabetes, starting tirzepatide was associated with lower risks of any, ischemic and hemorrhagic stroke than starting another GLP-1 drug. The absolute difference in stroke risk was 2.1 percentage points at one year.^[8] The authors are clear that “randomized trials are required before treatment recommendations can change.” For the rhythm side, see GLP-1s and atrial fibrillation.

Could GLP-1s help recovery after a stroke?

In animal stroke models, GLP-1 drugs reduced the size of the damaged area and improved function, possibly by reducing inflammation and oxidative stress. But a 2026 systematic review found that “evidence for improved clinical outcomes in humans remains limited.” The drugs appeared “safe and well-tolerated in both acute and chronic settings.”^[5] There is no evidence yet that starting a GLP-1 after a stroke improves recovery.

Who is most likely to benefit

• People with type 2 diabetes, where the trial evidence is strongest.^[1][2]
• People who have already had a stroke, who saw the largest relative reduction in the trial meta-analysis.^[2]
• People staying on treatment long term, because the stroke benefit grew after the first two years.^[2]
• People with established heart disease and obesity, who have the SELECT evidence for fewer combined cardiovascular events, strokes included.^[9]

A GLP-1 doesn't replace other stroke-prevention treatment your doctor has prescribed, such as blood pressure medicine, a statin, or a blood thinner for atrial fibrillation. For tirzepatide's cardiovascular trial in diabetes, see SURPASS-CVOT. For artery disease in the legs, see GLP-1s and peripheral artery disease.

Bottom line

For people with type 2 diabetes, GLP-1 drugs probably lower the risk of ischemic stroke modestly, by about 12–16% in trial meta-analyses, with the benefit growing over time and largest after a previous stroke. For people taking Wegovy or Zepbound for weight without diabetes, the drugs lower overall cardiovascular risk, but a stroke-specific benefit has not been shown. Newer observational studies are encouraging but can't settle the question. The answer will come from longer trials.