amsterdam_pete said:I want to bring up the cardiovascular angle on cardiovascular risk.
Pushing back on amsterdam_pete here. The "earlier than weight loss explains" argument is weaker than this thread makes it sound. Blood pressure and inflammatory markers move fast and are downstream of early weight loss, so the mechanism is not as cleanly separable as the summaries imply.
Dr.KarenChen said:My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.
SUSTAIN-6 was the first CVOT to show cardiovascular benefit with semaglutide, relevant to cardiovascular risk. In 3,297 T2DM patients with high CV risk: MACE HR 0.74 (95% CI 0.58-0.95, p=0.02)[1].
Notable: the retinopathy signal in SUSTAIN-6 (HR 1.76) was subsequently attributed to rapid A1C reduction in patients with pre-existing retinopathy — not a direct drug effect. This has been confirmed in longer-term follow-up studies.
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
BethLabQueen said:The "earlier than weight loss explains" argument is weaker than this thread makes it sound.
CRP reduction on cardiovascular risk — this is the lab result that excites me most:
Baseline hsCRP: 10.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 2.5 mg/L (moderate risk)
Month 12 hsCRP: 0.7 mg/L (low risk)
This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 17% to 5%. My cardiologist is genuinely impressed.
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Browse GL BiochemOne thing that is still open after Dr.RheumBOS’s answer:
Did your prescriber agree with that reading, and if not what was their objection?
Dr.NephBHM_UK said:CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 10.0 mg/L (high cardiovascular risk) Month 6…
6 month update on cardiovascular risk: down 53 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.