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Evidence-based GLP-1 & peptide discussion since 2023
ForumsCardiovascular OutcomesHas anyone dealt with tirzepatide cardiovascular safety? Page 2

Has anyone dealt with tirzepatide cardiovascular safety?

carlos_SATX Thu, Sep 18, 2025 at 10:20 PM 41 replies 1,657 viewsPage 2 of 9
COA_Karl
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Pennsylvania
Sep 19, 2025 at 12:58 AM#6
Dr.NutriCornell said:
The GIP arm is doing real work rather than padding the label.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The "tirzepatide is simply better" summary irritates me. It is better on mean weight loss, and the cardiovascular outcome evidence is far thinner than semaglutide's. If the reason for treating is cardiovascular risk rather than weight, the evidence base points the other way.

Last edited: Sep 19, 2025 at 1:58 AM
14 17matt_MKE, Dr.ReproEndo, lucas_SP_BR and 11 others
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dan_philly
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Jul 2024
Philadelphia, PA
Sep 19, 2025 at 1:59 AM#7

Adding the numbers, since they settle part of this. Relative versus absolute is the distinction that gets lost: a 20% relative reduction on a high baseline risk is a large absolute benefit, and the same relative figure on a low baseline risk is a small one.

15 18AmyNC_wife, SkepticalSean, Dr.CardioMD and 12 others
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carl_compliance
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Nov 2024
Raleigh, NC
Sep 19, 2025 at 3:00 AM#8
COA_Karl said:
The "tirzepatide is simply better" summary irritates me.

Adding the part of the answer the thread has not reached. SELECT is the trial that changed the framing of this class, because it was an outcome trial rather than a weight trial: about a 20% relative reduction in major adverse cardiovascular events in people with established cardiovascular disease and overweight or obesity, without diabetes. The effect appeared earlier than the weight-loss curve can comfortably explain, which is the basis for arguing that some of the benefit is direct — anti-inflammatory and vascular — rather than purely a consequence of weight.

That is the short version; the long version is somebody else's post.

16 19ricardo_MIA, BrianDallas92, labquiet_amy and 13 others
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marcus_mpls
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Nov 2024
Minneapolis, MN
Sep 19, 2025 at 4:00 AM#9

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

How much of the tirzepatide advantage is the GIP component and how much is simply that the dose ladder goes higher in receptor-occupancy terms?

17 20Dr.PathRoch, mona_PHX, andrew_nyc and 14 others
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carlos_SATX
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San Antonio, TX
Sep 19, 2025 at 8:50 AM#10

OP back with an update, since a thread like this is useless without one.

Reporting back after another eight months at the same dose. Still losing slowly, no new side effects, and no reason I can find to climb further.

35 10tommy_boulder, hyun_seoul, jim_asheville and 32 others
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