A large real-world study comparing tirzepatide and semaglutide in adults with type 2 diabetes showed that both drugs significantly reduced the risk of major cardiovascular events such as myocardial infarction, stroke and death. Tirzepatide did not increase cardiovascular risk compared with insulin glargine in the SURPASS-4 trial (hazard ratio 0.74; 95% CI 0.51-1.08), and meta-analyses confirmed its beneficial effect on reducing MACE and death from cardiovascular causes. Semaglutide in the SELECT trial reduced the relative risk of MACE by 20% (HR 0.80; 95% CI 0.72-0.90; p < 0.001) during a mean follow-up of 40 months. Both drugs also slightly lowered blood pressure and slightly increased heart rate. The researchers did not observe significant differences in cardiovascular protection between tirzepatide and semaglutide, although the companies emphasized the benefits of their products. In addition to cardiovascular benefits, tirzepate demonstrated better control of HbA1c levels and more significant weight loss compared with semaglutide. The incidence of hypoglycaemia was low with both drugs. Overall, these results confirm strong and early cardiovascular protection in patients with type 2 diabetes when treated with both tirzepatide and semaglutide[1][2][3][4][5][6].