HPLC_Greg said:

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

HPLC_Greg said:

...we don't know the long-term effects of cardiovascular risk...

This is a fair point, and I think intellectual honesty requires acknowledging it. GLP-1 agonists in their current form have ~8-10 years of human exposure data. That's not nothing, but it's not 30+ years either.

However: the risk-benefit calculation should also consider the KNOWN long-term effects of untreated obesity — diabetes, cardiovascular disease, cancer, joint destruction, reduced lifespan by 5-10 years.

Uncertainty about GLP-1 long-term safety vs certainty about obesity consequences. The calculus seems clear to me, but reasonable people can disagree.

HPLC_Greg said:

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

That reframing is the part I needed. Taking it to my next appointment.

Clinical perspective, offered as context rather than as advice.

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

Baseline hsCRP: 7.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 3.5 mg/L (moderate risk)
Month 12 hsCRP: 0.3 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 14% to 6%. My cardiologist is genuinely impressed.

Dr.PeteFamMed said:

CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 7.0 mg/L (high cardiovascular risk) Month 6 hsCRP:…

This matches mine closely enough to be worth saying so out loud.

Dr.PeteFamMed said:

CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 7.0 mg/L (high cardiovascular risk) Month 6 hsCRP:…

Metabolic syndrome resolution on cardiovascular risk: I went from meeting 3 of 5 diagnostic criteria to meeting ZERO after 11 months of treatment.

The 5 criteria (and my journey):

1. Waist circumference: 50" → 36" ✅ Resolved
2. Triglycerides: 222 → 97 ✅ Resolved
3. HDL: 34 → 54 ✅ Resolved
4. Blood pressure: 142/96 → 120/74 ✅ Resolved
5. Fasting glucose: 117 → 86 ✅ Resolved

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