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ForumsCardiovascular OutcomesBlood pressure went from scary to perfect - anyone else? — anyone have experience?

Blood pressure went from scary to perfect - anyone else? — anyone have experience?

SallyK_inj Mon, Jul 21, 2025 at 4:58 AM 9 replies 1,317 viewsPage 1 of 2
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SallyK_inj
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Jul 21, 2025 at 4:58 AM#1

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

Relative versus absolute is the distinction that gets lost: a 20% relative reduction on a high baseline risk is a large absolute benefit, and the same relative figure on a low baseline risk is a small one.

What would genuinely help is knowing how much of the SELECT benefit is plausibly independent of the weight loss, and whether that distinction changes anything practical.

If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

48 1amy_econ_NJ, bbq_ray_KC, oliver_london and 45 others
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DanielChem_CHI
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Jul 21, 2025 at 5:12 AM#2
SallyK_inj said:
Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
SallyK_inj said:
...cardiovascular risk is just another fad...

I understand the skepticism — we've all seen "miracle" weight loss solutions come and go. But consider what makes GLP-1 agonists different:

  • Phase 3 RCTs with thousands of participants (not 20-person pilot studies)
  • Published in NEJM, JAMA, Lancet (not press releases)
  • Replicated across multiple independent research groups
  • Proven cardiovascular and renal benefits beyond weight loss
  • Biological mechanism fully characterized at the receptor level

This isn't a fad — it's a new drug class supported by the highest level of clinical evidence. The comparison to past fads is understandable but inappropriate.

49 2Dr.DermMIA, fiona_VT, denise_HTX and 46 others
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NurseAsh_DET
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Jul 21, 2025 at 5:26 AM#3
DanielChem_CHI said:
SallyK_inj said: ...cardiovascular risk is just another fad...

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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SteveThurs
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Jul 21, 2025 at 5:40 AM#4
SallyK_inj said:
Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

This is my experience too, for whatever a second data point is worth. The detail I would add is minor and it is already implied above.

Last edited: Jul 21, 2025 at 9:40 AM
1 4DoseLogDan
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claudia_zurich
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Jul 21, 2025 at 6:54 AM#5

Clinical perspective, offered as context rather than as advice.

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.

2 5kevin_tulsa, Dr.PainCLE
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