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Glucagon-like peptide-1 receptor agonists as potential preventive and therapeutic agents in ischemic stroke 1 Department of Physiology, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada 2 Department of Surgery, Division of Anatomy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada 3 Department of Pharmacology and Toxicology, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada 4 Banting and Best Diabetes Centre, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada Advanced Neurology 2026 , 5(2), 025150027 Received: 7 April 2025 | Revised: 13 July 2025 | Accepted: 22 July 2025 | Published online: 11 September 2025 Stroke remains a significant contributor to mortality and morbidity worldwide, imposing a significant socioeconomic burden and underscoring the urgent need for both preventative and therapeutic strategies

The cardiovascular protection offered by GLP-1 receptor agonists stems from several complementary mechanisms: Anti-inflammatory effects through suppression of CRP, TNF-, and other inflammatory markers Substantial weight reduction, particularly with higher doses of newer agents Blood pressure modulation via direct vascular effects and enhanced natriuresis Improved endothelial function and lipid profiles Renal protective effects, including reduced albuminuria and slowed eGFR decline Though initially established in type 2 diabetes populations, recent evidence from the SELECT trial confirms these benefits extend to non-diabetic patients with obesity and established cardiovascular disease

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Treatment duration should be determined in consultation with a qualified healthcare provider