Dr.CardioMD 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:…

Pushing back on Dr.CardioMD here. The "earlier than weight loss explains" argument is weaker than this thread makes it sound. Blood pressure and inflammatory markers move fast and are downstream of early weight loss, so the mechanism is not as cleanly separable as the summaries imply.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

KarenAZ_mom said:

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

KarenAZ_mom 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.

NurseKim_ATL said:

The "earlier than weight loss explains" argument is weaker than this thread makes it sound.

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:

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

One thing that is still open after AmyNC_wife’s answer:

Was that from a primary source or from a summary of one?

Dr.NateNeph said:

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

Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:

• NT-proBNP: 63 pg/mL (normal, cardiac function preserved)
• Lp(a): 63 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 158 to 88 mg/dL (excellent response)
• Coronary calcium score: 0 (unchanged from baseline — reassuring)

The ApoB reduction is particularly meaningful — it's considered the best single predictor of cardiovascular risk. GLP-1 therapy seems to improve this consistently.