Dr.GutHealth said:

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off losartan entirely!

CRP reduction on cardiovascular risk — this is the lab result that excites me most:

Baseline hsCRP: 5.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 1.5 mg/L (moderate risk)
Month 12 hsCRP: 0.3 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 12% to 4%. My cardiologist is genuinely impressed.

One thing that is still open after Dr.GutHealth’s answer:

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

PharmacoVig_BOS said:

CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 5.0 mg/L (high cardiovascular risk) Month 6 hsCRP:…

I'm 55 years old and want to share my perspective on cardiovascular risk as an older member of this community.

My doctor was initially hesitant because of my age, but the SELECT trial included patients up to 72 and showed consistent benefit across age groups. We started at the lowest dose with closer monitoring.

13 months later: down 40 lbs, off atorvastatin, A1C from 8.0% to 5.5%. My cardiologist is thrilled. cardiovascular risk is absolutely relevant for older adults — don't let anyone tell you otherwise.

PharmacoVig_BOS said:

CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 5.0 mg/L (high cardiovascular risk) Month 6 hsCRP:…

PharmacoVig_BOS said:

...we don't know the long-term effects of cardiovascular risk...

This is a fair point, and I think intellectual honesty requires acknowledging it. GLP-1 agonists in their current form have ~8-10 years of human exposure data. That's not nothing, but it's not 30+ years either.

However: the risk-benefit calculation should also consider the KNOWN long-term effects of untreated obesity — diabetes, cardiovascular disease, cancer, joint destruction, reduced lifespan by 5-10 years.

Uncertainty about GLP-1 long-term safety vs certainty about obesity consequences. The calculus seems clear to me, but reasonable people can disagree.

PharmacoVig_BOS said:

CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 5.0 mg/L (high cardiovascular risk) Month 6 hsCRP:…

Bookmarking. The distinction being drawn above is the one nobody else makes.