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Evidence-based GLP-1 & peptide discussion since 2023
ForumsCardiovascular OutcomesHas anyone dealt with blood pressure went from scary to perfect - anyone else?? Page 3

Has anyone dealt with blood pressure went from scary to perfect - anyone else??

sophie_paris Thu, Oct 31, 2024 at 3:24 AM 39 replies 2,318 viewsPage 3 of 8
BariatricNurseD
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Nov 4, 2024 at 8:18 AM#11
LindaRN_retired said:
Dr.SportsMedIN said: ...we're creating a generation dependent on cardiovascular risk...

Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:

  • NT-proBNP: 46 pg/mL (normal, cardiac function preserved)
  • Lp(a): 56 nmol/L (genetic, unchanged — expected)
  • ApoB: dropped from 146 to 86 mg/dL (excellent response)
  • Coronary calcium score: 0 (unchanged from baseline — reassuring)

The ApoB reduction is particularly meaningful — it's considered the best single predictor of cardiovascular risk. GLP-1 therapy seems to improve this consistently.

6 4tony_orlando, Dr.NephBHM_UK, kim_atl_prep and 3 others
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Dr.DermMIA
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Nov 6, 2024 at 12:06 AM#12
COA_Karl said:
Metabolic syndrome resolution on cardiovascular risk: I went from meeting 5 of 5 diagnostic criteria to meeting ZERO after 10 months of treatment.

Thank you — that is the clearest version of this I have read, and I have read a lot of them. Taking it to my next appointment.

Last edited: Nov 6, 2024 at 2:06 AM
7 5Dr.RenalNash, LipidDoc_ATL, BariatricNurseD and 4 others
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MeganSA_TX
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Nov 7, 2024 at 3:55 PM#13
LindaRN_retired said:
Dr.SportsMedIN said: ...we're creating a generation dependent on cardiovascular risk...

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].

Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.

These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.

References:
[1] Hogan AE, et al. Diabetologia. 2014;57(4):781-784.
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lucas_SP_BR
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Nov 9, 2024 at 7:45 AM#14
sophie_paris 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.

References:
[1] Lincoff AM, et al. N Engl J Med. 2023;389(24):2221-2232.
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mike_mod
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Nov 10, 2024 at 11:36 PM#15

Moderator note: the sourcing question belongs in the vendor section and has been split out.

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