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Evidence-based GLP-1 & peptide discussion since 2023
ForumsCardiovascular OutcomesSELECT trial: 20% MACE reduction — looking for input Page 5

SELECT trial: 20% MACE reduction — looking for input

TinaHashiRN Sun, Jan 4, 2026 at 9:06 AM 29 replies 1,384 viewsPage 5 of 6
anna.melb_AU
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Melbourne, AU
Jan 5, 2026 at 5:02 PM#21
quinn_sf said:
Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically.

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off lisinopril entirely! My cardiologist is thrilled.

If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.

37 12DerekSJ_a1c, paige_pharma, emma_london and 34 others
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Dr.ReproEndo
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Jan 2024
Scottsdale, AZ
Jan 5, 2026 at 11:19 PM#22
quinn_sf said:
Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically.

Metabolic syndrome resolution on cardiovascular risk: I went from meeting 4 of 5 diagnostic criteria to meeting ZERO after 9 months of treatment.

The 5 criteria (and my journey):

  1. Waist circumference: 48" → 36" ✅ Resolved
  2. Triglycerides: 274 → 99 ✅ Resolved
  3. HDL: 32 → 56 ✅ Resolved
  4. Blood pressure: 144/96 → 122/76 ✅ Resolved
  5. Fasting glucose: 124 → 84 ✅ Resolved

Metabolic syndrome reversal is, in my view, the most medically significant outcome of GLP-1 therapy.

Last edited: Jan 6, 2026 at 12:19 AM
36 11andrew_nyc, Dr.EndoEP, GraceAZ_72 and 33 others
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RetaRick_CA
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Jan 2024
California
Jan 6, 2026 at 5:37 AM#23
quinn_sf said:
Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically.

This is exactly what I could not find anywhere else. Taking it to my next appointment.

35 10DadBodDave, AmyNC_wife, SkepticalSean and 32 others
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chris_chi24
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Sep 2024
Chicago, IL
Jan 6, 2026 at 11:55 AM#24

From the other side of the consultation, briefly.

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.
Last edited: Jan 6, 2026 at 2:55 PM
34 9PurityPaulOR, MaxMetOK, MounjBrad and 31 others
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pete_nash
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Nashville, TN
Jan 6, 2026 at 6:13 PM#25
chris_chi24 said:
Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling,…

This matches mine closely enough to be worth saying so out loud. Posting only so the count is not one.

33 8sarah.morrison, NeuroNate, JessicaH_TX and 30 others
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