amsterdam_pete said:

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

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.

SallyK_inj said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

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.

FDA_TrackerJim said:

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

Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically. My geriatrician recommended it after years of failed interventions.

13 months later: down 58 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.

To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.

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

Did your prescriber agree with that reading, and if not what was their objection?

Dr.Martinez said:

Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically.

6 month update on cardiovascular risk: down 44 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.