PharmacoVig_BOS said:

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

Second this. The detail I would add is minor and it is already implied above.

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

Update. I did go to 2.4mg in the end, and the honest report is that it bought me less than the step before it and cost me two bad weeks. Worth knowing rather than worth repeating.

PharmacoVig_BOS said:

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

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

Baseline hsCRP: 8.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 3.5 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 15% to 6%. My cardiologist is genuinely impressed.

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

What did you change at the same time, and can you separate the two now?

MaxMetOK said:

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

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

• NT-proBNP: 52 pg/mL (normal, cardiac function preserved)
• Lp(a): 52 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 152 to 92 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.