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Evidence-based GLP-1 & peptide discussion since 2023
ForumsCardiovascular OutcomesCoronary artery calcium score changes on GLP-1 — anyone have experience?

Coronary artery calcium score changes on GLP-1 — anyone have experience?

matt_MKE Tue, Feb 11, 2025 at 7:17 PM 9 replies 1,691 viewsPage 1 of 2
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matt_MKE
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Milwaukee, WI
Feb 11, 2025 at 7:17 PM#1

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

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.

The bit I cannot resolve on my own is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.

I have searched first, so if this is covered somewhere point me at it and I will read it.

7 10andrew_nyc, Dr.EndoEP, GraceAZ_72 and 4 others
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julia.endo
Senior Member
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Feb 2024
Cincinnati, OH
Feb 11, 2025 at 9:05 PM#2
matt_MKE said:
My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

CRP reduction on cardiovascular risk — this is the lab result that excites me most:

Baseline hsCRP: 5.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 1.5 mg/L (moderate risk)
Month 12 hsCRP: 0.6 mg/L (low risk)

This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 12% to 4%. My cardiologist is genuinely impressed.

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pete_manc_UK
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Mar 2024
Manchester, UK
Feb 11, 2025 at 10:53 PM#3
julia.endo said:
CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 5.0 mg/L (high cardiovascular risk) Month 6 hsCRP:…
julia.endo said:
...cardiovascular risk is just another fad...

I understand the skepticism — we've all seen "miracle" weight loss solutions come and go. But consider what makes GLP-1 agonists different:

  • Phase 3 RCTs with thousands of participants (not 20-person pilot studies)
  • Published in NEJM, JAMA, Lancet (not press releases)
  • Replicated across multiple independent research groups
  • Proven cardiovascular and renal benefits beyond weight loss
  • Biological mechanism fully characterized at the receptor level

This isn't a fad — it's a new drug class supported by the highest level of clinical evidence. The comparison to past fads is understandable but inappropriate.

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JenMemphis
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Jan 2025
Memphis, TN
Feb 12, 2025 at 12:41 AM#4
matt_MKE said:
My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

Same pattern here, and in the same order. Posting only so the count is not one.

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Dr.NateNeph
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Feb 12, 2025 at 11:18 AM#5

Clinical perspective, offered as context rather than as advice.

matt_MKE said:
...we're creating a generation dependent on cardiovascular risk...

I understand the concern, but consider this analogy: are we "creating a generation dependent on" blood pressure medication? Cholesterol medication? Thyroid medication?

Obesity is a chronic disease with biological drivers. Treating it with medication is no different from treating any other chronic condition. The "dependency" framing implies weakness or moral failure — neither of which is accurate.

If ongoing medication is what keeps someone healthy, that's successful treatment, not dependency.

Last edited: Feb 12, 2025 at 1:18 PM
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