Arterial stiffness reduction on GLP-1 — pulse wave velocity studies

Dr.RaviCardio said:

SELECT is the trial that changed the framing of this class, because it was an outcome trial rather than a weight trial: about a 20% relative reduction…

Senior perspective on cardiovascular risk: I'm 70 years old and started this journey skeptically. My internist recommended it after years of failed interventions.

8 months later: down 38 lbs, more mobile, pain reduced, medications simplified. My quality of life has improved dramatically. I wish this existed 20 years ago.

To other older adults hesitating: the SELECT trial proved benefit in our age group. You deserve to feel good in your body regardless of age.

A narrower follow-up, since the general answer is now clear:

How long did you give it before you decided it was working?

TirzTom said:

Senior perspective on cardiovascular risk: I'm 70 years old and started this journey skeptically.

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off metoprolol entirely! My cardiologist is thrilled.

If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.

TirzTom said:

Senior perspective on cardiovascular risk: I'm 70 years old and started this journey skeptically.

Metabolic syndrome resolution on cardiovascular risk: I went from meeting 5 of 5 diagnostic criteria to meeting ZERO after 10 months of treatment.

The 5 criteria (and my journey):

1. Waist circumference: 49" → 37" ✅ Resolved
2. Triglycerides: 227 → 107 ✅ Resolved
3. HDL: 33 → 59 ✅ Resolved
4. Blood pressure: 147/93 → 120/74 ✅ Resolved
5. Fasting glucose: 122 → 85 ✅ Resolved

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

Dr.AddMedPHL said:

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

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].

Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.

These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.