Dr.RaviCardio said:The dose-response is real but shallow at the top.
That reframing is the part I needed. Adding it to my notes with a link back to this thread.
From the other side of the consultation, briefly.
Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off metoprolol entirely! My cardiologist is thrilled.
If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.
lisa_labSD said:The mechanism that matters here is not stomach emptying, it is central.
Pushing back on lisa_labSD here. The trial means are being read too generously in this thread. STEP populations were selected, supported, and titrated by protocol, and the real-world curves are consistently a few points worse. That difference is not noise, it is what happens when you remove the study infrastructure.
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Browse GL Biochempam_stl said:SELECT is the trial that changed the framing of this class, because it was an outcome trial rather than a weight trial: about a 20% relative reduction…
CRP reduction on cardiovascular risk — this is the lab result that excites me most:
Baseline hsCRP: 9.0 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 16% to 5%. My cardiologist is genuinely impressed.