labquiet_amy said:I'm 48 years old and want to share my perspective on cardiovascular risk as an older member of this community.
This is where I part company with the consensus forming above. 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.
FranDenver said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
SUSTAIN-6 was the first CVOT to show cardiovascular benefit with semaglutide, relevant to cardiovascular risk. In 3,297 T2DM patients with high CV risk: MACE HR 0.74 (95% CI 0.58-0.95, p=0.02)[1].
Notable: the retinopathy signal in SUSTAIN-6 (HR 1.76) was subsequently attributed to rapid A1C reduction in patients with pre-existing retinopathy — not a direct drug effect. This has been confirmed in longer-term follow-up studies.
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
InsuranceTom said:The "earlier than weight loss explains" argument is weaker than this thread makes it sound.
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: 0.5 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.
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View ResultsA narrower follow-up, since the general answer is now clear:
How long did you give it before you decided it was working?
TrialTracker_MD said: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:…
Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:
- NT-proBNP: 48 pg/mL (normal, cardiac function preserved)
- Lp(a): 48 nmol/L (genetic, unchanged — expected)
- ApoB: dropped from 148 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.