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Evidence-based GLP-1 & peptide discussion since 2023
ForumsCardiovascular OutcomesMy cardiologist just high-fived me at my checkup lol

My cardiologist just high-fived me at my checkup lol

BethLabQueen Thu, May 14, 2026 at 7:01 AM 19 replies 504 viewsPage 1 of 4
BethLabQueen
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May 14, 2026 at 7:01 AM#1

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

What I am trying to establish is how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.

I have searched first, so if this is covered somewhere point me at it and I will read it.

39 9maya_sedona, stefan_berlin, Dr.EM_Chicago and 36 others
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Dr.SportsMedIN
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May 14, 2026 at 7:30 AM#2
BethLabQueen said:
My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 → elevated homocysteine → increased cardiovascular risk marker.

The connection: B12 is a cofactor for homocysteine metabolism. Without adequate B12, homocysteine accumulates. This is ironic — taking a CV-protective medication while developing a CV risk factor from reduced nutrition.

Solution: comprehensive vitamin supplementation and regular lab monitoring. Don't let the medication's benefits be undermined by nutritional deficiencies.

38 8lisa_labSD, adam_van, Dr.SurgeonPGH and 35 others
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InsuranceTom
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May 14, 2026 at 7:59 AM#3
Dr.SportsMedIN said:
Vitamin deficiency cascade with cardiovascular risk: after 6+ months of reduced food intake, I developed a subtle but important pattern: low B12 →…

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.

37 7Dr.ReproEndo, lucas_SP_BR, lisa_labSD and 34 others
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B12Beth
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May 14, 2026 at 8:27 AM#4
BethLabQueen said:
My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

Same pattern here, and in the same order.

36 6marco_milano, pam_columbus, nick_SD_fit and 33 others
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Dr.ObesityMed
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May 14, 2026 at 11:03 AM#5

From the other side of the consultation, briefly.

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.

References:
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
Last edited: May 14, 2026 at 5:03 PM
35 5A1cHero_PHX, Dr.RenalNash, LipidDoc_ATL and 32 others
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