My cardiologist just high-fived me at my checkup lol — July 2024

stefan_berlin said:

I'm 67 years old and want to share my perspective on cardiovascular risk as an older member of this community.

stefan_berlin said:

...we're creating a generation dependent on cardiovascular risk...

I understand the concern, but consider this analogy: are we "creating a generation dependent on" blood pressure medication? Cholesterol medication? Thyroid medication?

Obesity is a chronic disease with biological drivers. Treating it with medication is no different from treating any other chronic condition. The "dependency" framing implies weakness or moral failure — neither of which is accurate.

If ongoing medication is what keeps someone healthy, that's successful treatment, not dependency.

stefan_berlin said:

I'm 67 years old and want to share my perspective on cardiovascular risk as an older member of this community.

Thank you for spelling out the reasoning rather than just the conclusion. Sending this to two other people who asked me the same thing last week.

From the other side of the consultation, briefly.

Dizziness and cardiovascular risk: I was lightheaded for the first 2 weeks. Root cause was a combination of reduced caloric intake and mild dehydration.

Fix: minimum 80-100oz water daily, don't skip meals even if you're not hungry (eat small protein-rich snacks), and stand up slowly from sitting/lying positions. Also check your blood pressure — GLP-1-induced weight loss can make BP meds too strong, requiring dose reduction.

Dr.RheumBOS said:

Dizziness and cardiovascular risk: I was lightheaded for the first 2 weeks.

Can confirm. Same sequence, different timescale. Nothing to add that would improve it.

Dr.RheumBOS said:

Dizziness and cardiovascular risk: I was lightheaded for the first 2 weeks.

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: 2.5 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 14% to 5%. My cardiologist is genuinely impressed.