Adding the clinical framing, because it changes how the question reads.
I want to bring up the cardiovascular angle on cardiovascular risk.
The SELECT trial demonstrated a 20% reduction in MACE with semaglutide 2.4mg[1]. This is practice-changing because the CV benefit appears to be independent of the degree of weight loss — suggesting direct vascular and anti-inflammatory mechanisms.
For cardiovascular risk, this means we need to think beyond the primary outcome and consider the cardiovascular implications. The all-cause mortality reduction (HR 0.81) is the most clinically meaningful signal.
[1] Lincoff AM, et al. N Engl J Med. 2023;389(24):2221-2232.
josh_phd_bmore said:MASHdoc_SA said: ...cardiovascular risk is just another fad...
Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:
Weight: consistent downtrend, -2.3 lbs/week average
Fasting glucose (finger stick): stable at 84 mg/dL
Blood pressure (home): 118/74 average
Resting heart rate: 64 bpm (down from 80)
Waist circumference: down 14 inches total
The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.
josh_phd_bmore said:MASHdoc_SA said: ...cardiovascular risk is just another fad...
I'm 67 years old and want to share my perspective on cardiovascular risk as an older member of this community.
My doctor was initially hesitant because of my age, but the SELECT trial included patients up to 72 and showed consistent benefit across age groups. We started at the lowest dose with closer monitoring.
12 months later: down 59 lbs, off lisinopril, A1C from 7.8% to 5.4%. My cardiologist is thrilled. cardiovascular risk is absolutely relevant for older adults — don't let anyone tell you otherwise.
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View ResultsOne thing that is still open after josh_phd_bmore’s answer:
What did you change at the same time, and can you separate the two now?
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