Stopping GLP-1 drugs doubles heart-attack risk: what Canadian patients need to know about discontinuation

This article is for informational purposes only and is not medical advice. Consult your Canadian healthcare provider about your situation.

A study reported by CTV News on November 12, 2026 found that patients who discontinue GLP-1 receptor agonist therapy face approximately twice the risk of heart attack, stroke, or death compared with patients who remain on treatment. GLP-1 receptor agonists are a class of injectable and oral medications that mimic the glucagon-like peptide-1 hormone to lower blood sugar, reduce appetite, and, as a growing body of evidence shows, protect the cardiovascular system. The finding adds weight to what cardiologist and epidemiologist Dr. Christopher Labos described as evidence that GLP-1 medications "protect your heart," and it carries direct implications for the hundreds of thousands of Canadians currently prescribed these drugs.

For a Canadian patient on semaglutide (sold in Canada as Ozempic for type 2 diabetes and as Wegovy for chronic weight management, both Health Canada-approved) or liraglutide (Victoza for diabetes, Saxenda for weight management), the practical question is whether cost, supply shortages, or a prescriber's decision to stop the drug could be putting them at elevated cardiovascular risk. The answer, based on this study, appears to be yes. That makes the coverage patchwork across provincial drug plans a patient-safety issue, not just a financial one.

What this means in Canada

Health Canada has approved semaglutide under two brand names: Ozempic (for type 2 diabetes management) and Wegovy (for weight management in adults with obesity or overweight with at least one weight-related condition). Liraglutide is approved as Victoza (diabetes) and Saxenda (weight management). Tirzepatide (Mounjaro, approved for type 2 diabetes) is a dual GIP/GLP-1 agonist with a related but distinct mechanism.

Provincial coverage varies widely. In Ontario, OHIP's drug benefit program (the Ontario Drug Benefit, or ODB) covers semaglutide and liraglutide for type 2 diabetes under specific criteria, but coverage for the weight-management indications (Wegovy, Saxenda) is not standard across most provincial formularies as of late 2026. Quebec's RAMQ covers some GLP-1 agents for diabetes but has not broadly listed Wegovy. British Columbia's PharmaCare and Alberta's AHCIP follow similar patterns: diabetes indication covered with conditions, obesity indication largely not. This means many patients using these drugs for weight management pay entirely out of pocket, with Wegovy running roughly CAD $350 to $500 per month, creating real pressure to stop.

The Society of Obstetricians and Gynaecologists of Canada (SOGC) has not issued a position statement specifically on GLP-1 discontinuation risk. The Canadian Diabetes Association (now Diabetes Canada) does include GLP-1 receptor agonists in its clinical practice guidelines as preferred agents for people with type 2 diabetes and established cardiovascular disease, citing their cardioprotective profile. That guidance predates this specific discontinuation study but is directionally consistent with its findings.

Canadian telehealth platforms including Felix, Maple, and Telus Health can prescribe GLP-1 medications where clinically appropriate, and Science & Humans (scienceandhumans.com) offers metabolic and hormone-related care including these medications. None of these platforms change the underlying provincial coverage situation: a prescription is accessible, but the cost burden remains.

What changed

Previous landmark trials, including the SUSTAIN-6 and LEADER trials, established that GLP-1 drugs reduce major adverse cardiovascular events in people with type 2 diabetes and high cardiovascular risk. The SELECT trial (2023) extended that finding to people with obesity but without diabetes. What this newer analysis adds is a discontinuation signal: stopping the drug appears to reverse the cardiovascular protection relatively quickly, roughly doubling the rate of serious events compared with continued users.

This is biologically plausible. GLP-1 receptor agonists reduce inflammation, lower blood pressure, improve lipid profiles, and reduce body weight, all factors that affect cardiovascular risk. When the drug is stopped, those effects fade. Weight typically returns within months, as documented in the STEP 1 trial extension, and the metabolic benefits follow.

The study, as reported by CTV News, does not appear to be a randomized controlled trial of discontinuation (it would be unethical to randomize patients to stop a drug known to reduce heart attacks). It is most likely an observational or registry-based analysis, which means confounding is possible: patients who stop may do so because they are sicker, can no longer afford the drug, or have experienced side effects that themselves signal elevated risk. The direction of the effect, however, aligns with the mechanistic evidence and with what clinicians have observed clinically.

What Canadian patients should know

If you are taking a GLP-1 medication for type 2 diabetes or cardiovascular risk reduction, do not stop without speaking to your prescriber. This applies even if you are stopping because of cost, a temporary supply shortage, or side effects. Your doctor may be able to switch you to a covered formulation, adjust the dose, or help you access manufacturer support programs. Novo Nordisk Canada, which makes Ozempic and Wegovy, has a patient support program called Cornerstones4Care that some patients have used to bridge coverage gaps.

If you are taking a GLP-1 drug solely for weight loss and your provincial plan does not cover it, the cost-versus-risk conversation is more complex. The cardiovascular benefit is real, but it has to be weighed against what you can sustain long-term. A prescriber can help you think through whether a lower dose, a different drug in the class, or a planned taper with close monitoring is appropriate for your situation.

Patients in provinces with broader pharmacare coverage should check whether their specific drug and indication are listed. Formulary status changes, and some provinces have added GLP-1 agents to their exceptional drug status programs. A pharmacist can confirm current coverage in your province.

Limitations and open questions

The study as reported by CTV News has not been fully detailed in this article's source material: the journal, sample size, follow-up duration, and whether the cohort was primarily a diabetes population or a broader obesity population are not specified. Those details matter. A doubled relative risk sounds alarming, but the absolute risk depends heavily on the baseline risk of the population studied. A 45-year-old with no prior cardiovascular events faces a very different absolute risk than a 68-year-old who has already had a heart attack.

Health Canada has not issued specific guidance on discontinuation risk or on minimum treatment durations for cardiovascular benefit. The SOGC has not weighed in. Diabetes Canada's guidelines recommend continued use for people with established cardiovascular disease, but do not address what happens when patients stop due to cost or access barriers, a gap that advocates have flagged as a policy problem.

It also remains unclear whether the risk returns to baseline gradually or spikes sharply in the weeks after stopping. That timing question has real clinical relevance for patients who need to pause treatment for surgery, pregnancy planning, or other medical reasons.

What is clear is that for Canadians with type 2 diabetes and cardiovascular disease, GLP-1 therapy is not a drug you start and stop casually. The coverage gaps that force that decision deserve attention from provincial health ministries.

This article is for informational purposes only and is not medical advice. Consult your Canadian healthcare provider about your situation.

Editorial note

Hormone Journal articles are written by our editorial team and reviewed against published clinical guidelines, with a focus on Canadian patient access. We do not promote specific clinics or providers.