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Could Retatrutide Help Treat Pulmonary Hypertension? Experts Weigh In

Following reports of a compassionate use patient with pulmonary hypertension receiving retatrutide, STAT spoke with cardiology experts about the potential of GLP-1 drugs and triple agonists for this complex condition.

The revelation that a 79-year-old patient with obesity, sleep apnea, and pulmonary hypertension received Eli Lilly’s experimental triple-agonist retatrutide through a compassionate use program has sparked a broader medical conversation: could drugs like retatrutide help treat pulmonary hypertension?

STAT News examined this question in a June 26 article featuring interviews with leading pulmonary hypertension specialists, while MedPage Today highlighted the story in its June 30 Endo Break roundup. The answer, experts say, is nuanced — and depends heavily on which form of pulmonary hypertension is being considered.

Understanding Pulmonary Hypertension

Pulmonary hypertension (PH) is high blood pressure in the blood vessels of the lungs — a condition that affects approximately 1% of the world’s population, or about 82 million people. But as Paul Forfia, director of the Emory Healthcare Pulmonary Hypertension, Right Heart Failure and CTEPH Program, explained to STAT, the term covers vastly different disease states.

“Pulmonary hypertension is nothing more than elevated blood pressure in the blood vessels of the lungs,” Forfia said. “That can be something that is very serious and life-threatening and life-altering, or it can be a whole lot of nothing, depending on the type of pulmonary hypertension that someone has.”

PH is classified into five groups:

  • Group 1 (Pulmonary Arterial Hypertension): A rare, severe form where blood vessels in the lungs narrow and stiffen. Often affects younger women with autoimmune conditions.
  • Group 2 (most common, ~60% of cases): Caused by left-sided heart disease where the heart doesn’t pump or relax properly.
  • Group 3: Arises from chronic lung diseases like COPD or emphysema.
  • Group 4: Caused by chronic blood clots in the lungs — the only form that can potentially be cured through surgery.
  • Group 5: A catch-all category for other underlying causes including sickle cell disease, thyroid disorders, and chronic kidney failure.

The GLP-1 Connection

The interest in GLP-1 drugs — and retatrutide specifically — for pulmonary hypertension stems from the well-established benefits of this drug class on cardiovascular and metabolic health. Retatrutide goes a step further by targeting three receptors simultaneously: GLP-1, GIP, and glucagon, potentially offering broader therapeutic effects than single-agonist drugs.

Vallerie McLaughlin, director of the pulmonary hypertension program at the University of Michigan, told STAT she sees a scientific rationale. “I think because the GLP-1s can help with inflammation and stress on the heart from obesity and metabolic syndrome, they may be helpful in pulmonary hypertension due to any cause, but especially in patients who have pulmonary hypertension due to heart failure with preserved ejection fraction, where they have been well studied.”

In heart failure with preserved ejection fraction (HFpEF), the heart pumps normally but is too stiff to fill properly — and GLP-1s have already been shown to lower the risk of complications and improve symptoms in these patients.

Early Research, Cautious Optimism

While the evidence base is still developing, several studies suggest a potential link:

A September 2025 preprint from a Vanderbilt University team (published on medRxiv and not yet peer-reviewed) found an association between GLP-1 use and a lower risk of pulmonary hypertension in a large retrospective study of U.S. veterans with type 2 diabetes. A May 2025 review in the American Heart Journal Plus: Cardiology Research and Practice called for prospective trials to confirm the connection.

What is clear is that obesity significantly compounds the problem. Forfia described the cascade: “What happens is the patient becomes far more sick in the context of any given level of pulmonary hypertension in the context of the added problems of obesity, particularly when the person is morbidly obese. When a person is sufficiently obese, they literally can’t properly breathe, get oxygen into their bloodstream, get carbon dioxide out of their bloodstream.”

This condition — obesity hypoventilation syndrome — can directly cause PH through chronic low oxygen levels that stimulate the pulmonary arteries to constrict. The 79-year-old compassionate use patient had all three interrelated conditions: obesity, sleep apnea, and pulmonary hypertension.

Expert Perspectives

Roxana Sulica, director of the pulmonary hypertension program at NYU Langone Health, told STAT she’d like to see a clearer distinction drawn between group 1 pulmonary arterial hypertension — a rare vascular disease requiring specialized treatment — and the more common group 2 PH driven by cardiometabolic conditions.

“For people with a combination of health problems that we all suffer as we get old — the obesity, diabetes, sleep apnea — maybe for these people, all these weight loss drugs would be great,” she said. “They would directly benefit from treating the root of the evil.”

Forfia noted that patients on GLP-1s who lose significant weight report dramatic improvements: walking farther, faster, with less effort. Beyond subjective improvement, objective markers improve too — fluid retention and cardiac failure often resolve, and patients require less diuretic medication.

Still, all experts cautioned that the research is not yet advanced enough to draw firm conclusions. Prospective randomized trials are needed to determine whether GLP-1 drugs and triple agonists like retatrutide can meaningfully improve outcomes in pulmonary hypertension patients.

Canadian Context

Pulmonary hypertension affects Canadians at similar rates to the global population — roughly 1 in 100. In Canada, specialized PH clinics exist in major centres including Toronto’s University Health Network, the Montreal Heart Institute, and Vancouver General Hospital, but access can be a challenge for patients in rural and remote communities.

The overlap between obesity, sleep apnea, and pulmonary hypertension is particularly relevant to Canada, where obesity rates have been rising steadily. According to Statistics Canada, nearly 30% of Canadian adults are living with obesity, placing a significant portion of the population at risk for the obesity-hypoventilation-PH cascade.

For Canadian patients with PH who also struggle with obesity, the emergence of effective weight-loss therapies like retatrutide could represent a meaningful adjunct to existing treatments — provided the drug receives Health Canada approval and becomes accessible through provincial formularies.

The compassionate use case has also highlighted differences in drug access between the U.S. and Canada. Health Canada’s Special Access Programme provides a structured pathway for patients to request unapproved therapies, but Eli Lilly has not disclosed whether it has received or approved any Canadian compassionate use requests for retatrutide.

What’s Next

Eli Lilly plans to file retatrutide for regulatory approval later this year, which could lead to a commercial launch in Canada by 2027. As the drug progresses toward market, researchers will be watching for clinical trials specifically examining its effects on pulmonary hypertension — a potential new indication that could expand the drug’s therapeutic reach well beyond obesity and diabetes.

For now, the message from experts is one of measured optimism: the scientific rationale is promising, but the evidence is not yet there. As McLaughlin summed it up: “I think those drugs do a lot of different things, in addition to weight loss and reduced inflammation.” Whether those effects translate into meaningful outcomes for pulmonary hypertension patients will depend on the rigorous clinical trials still to come.

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