A narrower follow-up, since the general answer is now clear:
Did your prescriber agree with that reading, and if not what was their objection?
mel_PDX said:The gap between trial results and real-world results is consistent and it is not fraud.
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).
From SELECT trial: MACE at 39 months — 6.5% semaglutide vs 8.0% placebo. ARR = 1.5%. NNT = 67 over 3.3 years.
Compare to established therapies:
| Intervention | NNT | Timeframe |
|---|---|---|
| Semaglutide (MACE) | 67 | 3.3 years |
| Statins primary prevention (MI) | ~100 | 5 years |
| Aspirin secondary prevention | ~77 | 2 years |
These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.
mel_PDX said:The gap between trial results and real-world results is consistent and it is not fraud.
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.
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View Resultsmel_PDX said:The gap between trial results and real-world results is consistent and it is not fraud.
Saving this. It is the first explanation that did not require me to already understand it.
Clinical perspective, offered as context rather than as advice.
Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically. My geriatrician recommended it after years of failed interventions.
9 months later: down 53 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.