COA_Karl said:

Senior perspective on cardiovascular risk: I'm 62 years old and started this journey skeptically.

I read this differently from COA_Karl, on substance rather than tone. 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.

BiostatsBrad said:

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).

From SELECT trial: MACE at 39 months — 6.5% semaglutide vs 8.0% placebo. ARR = 1.5%. NNT = 67 over 3.3 years.

Compare to established therapies:

These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.

NeuroNate said:

The "earlier than weight loss explains" argument is weaker than this thread makes it sound.

6 month update on cardiovascular risk: down 60 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.

Following on from matt_MKE — and this may be the naive question:

What did you change at the same time, and can you separate the two now?

Dr.RheumBOS said:

6 month update on cardiovascular risk: down 60 lbs, off blood pressure meds, A1C normalized.

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.