COA_Karl said:

Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. 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.

MikeNYC_runner said:

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

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.

Dr.NutriCornell 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 andrew_nyc — and this may be the naive question:

Was that from a primary source or from a summary of one?

claudia_zurich 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 losartan 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.