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Evidence-based GLP-1 & peptide discussion since 2023
ForumsProgress & Lab ResultsBlood pressure normalized — anyone have experience? Page 6

Blood pressure normalized — anyone have experience?

Dr.KarenChen Thu, Oct 31, 2024 at 1:03 PM 45 replies 2,471 viewsPage 6 of 9
tammy_FL
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Tampa, FL
Nov 25, 2024 at 4:56 PM#26
traveltech_sara said:
Dizziness and cardiovascular risk: I was lightheaded for the first 3 weeks.

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

From SELECT trial: MACE at 39 months — 6.5% semaglutide vs 8.0% placebo. ARR = 1.5%. NNT = 67 over 3.3 years.

Compare to established therapies:

InterventionNNTTimeframe
Semaglutide (MACE)673.3 years
Statins primary prevention (MI)~1005 years
Aspirin secondary prevention~772 years

These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.

34 7Dr.LipidDallas, alex_tucson, kevin_tulsa and 31 others
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TrialTracker_MD
Senior Member
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Jan 2024
Maryland
Nov 28, 2024 at 9:38 PM#27
traveltech_sara said:
Dizziness and cardiovascular risk: I was lightheaded for the first 3 weeks.

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.
35 8stefan_berlin, Dr.EM_Chicago, pete_RVA and 32 others
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MounjBrad
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Oct 2024
Kentucky
Dec 2, 2024 at 2:21 AM#28

A narrower follow-up, since the general answer is now clear:

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

36 9nick_SD_fit, ben_calgary, patPC_UT and 33 others
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marcus_mpls
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1,123
Nov 2024
Minneapolis, MN
Dec 5, 2024 at 7:06 AM#29
TrialTracker_MD said:
Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling,…

Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:

Weight: consistent downtrend, -2.1 lbs/week average
Fasting glucose (finger stick): stable at 88 mg/dL
Blood pressure (home): 116/74 average
Resting heart rate: 68 bpm (down from 84)
Waist circumference: down 18 inches total

The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.

Last edited: Dec 5, 2024 at 12:06 PM
37 10Dr.PathRoch, mona_PHX, andrew_nyc and 34 others
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Dr.KarenChen
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San Francisco, CA
Dec 8, 2024 at 11:53 AM#30
TrialTracker_MD said:
Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling,…

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.
9 7sarah_nash92, FitDadDave, RunnerRach and 6 others
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