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.
PeptideSynthNJ said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
6 month update on cardiovascular risk: down 35 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.
InsuranceTom said:6 month update on cardiovascular risk: down 35 lbs, off blood pressure meds, A1C normalized.
Mendelian randomization evidence supporting GLP-1 pathway modulation for cardiovascular risk: genetic variants in the GLP1R gene region associated with lower BMI also show associations with reduced cardiovascular risk, confirming a causal pathway[1].
This "natural experiment" (people born with genetically higher GLP-1 signaling being leaner and healthier) provides orthogonal evidence supporting the pharmacological approach. When genetic epidemiology, clinical trials, and mechanistic studies all converge, confidence in the therapeutic approach is high.
Community-driven peptide testing and vendor rating platform. Transparent results. Unbiased analysis. Trusted by thousands.
View ResultsPeptideSynthNJ 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.
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.