NNT for MACE prevention — July 2024

FDA_TrackerJim said:

I'm 62 years old and want to share my perspective on cardiovascular risk as an older member of this community.

Filing a mild objection. Mild because I might be wrong; an objection because nobody has addressed the case that does not fit. The "earlier than weight loss explains" argument is weaker than this thread makes it sound. Blood pressure and inflammatory markers move fast and are downstream of early weight loss, so the mechanism is not as cleanly separable as the summaries imply.

Correct me if the detail matters more than I have assumed.

gary_naperville said:

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

CRP reduction on cardiovascular risk — this is the lab result that excites me most:

Baseline hsCRP: 5.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 2.5 mg/L (moderate risk)
Month 12 hsCRP: 0.6 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 12% to 5%. My cardiologist is genuinely impressed.

Dr.PainCLE said:

The "earlier than weight loss explains" argument is weaker than this thread makes it sound.

Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically. My internist recommended it after years of failed interventions.

8 months later: down 46 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.

One thing that is still open after nick_newbie’s answer:

How would you tell the difference between that and the alternative explanation?

Dr.ObesityMed said:

Senior perspective on cardiovascular risk: I'm 68 years old and started this journey skeptically.

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:

These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.