pete_manc_UK said:

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

Lp(a) and cardiovascular risk: a nuance that matters. Unlike most lipid markers, Lp(a) is 90%+ genetically determined and doesn't really change with weight loss or GLP-1 therapy.

My Lp(a) has remained at 48 nmol/L across all time points. If yours is elevated (>50 nmol/L), you need additional risk mitigation strategies regardless of your GLP-1 response. Don't assume your medication is covering all cardiovascular risk factors.

Dr.SleepRoch said:

Lp(a) and cardiovascular risk: a nuance that matters.

I'm 67 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.

17 months later: down 54 lbs, off metoprolol, A1C from 8.8% to 5.5%. My cardiologist is thrilled. cardiovascular risk is absolutely relevant for older adults — don't let anyone tell you otherwise.

pete_manc_UK said:

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

This is my experience too, for whatever a second data point is worth.

Clinical perspective, offered as context rather than as advice.

6 month update on cardiovascular risk: down 45 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.