Semaglutide cardiovascular benefit independent of weight loss — March 2026

TrialTracker_MD said:

6 month update on cardiovascular risk: down 52 lbs, off blood pressure meds, A1C normalized.

Senior perspective on cardiovascular risk: I'm 67 years old and started this journey skeptically. My geriatrician recommended it after years of failed interventions.

9 months later: down 55 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 TrialTracker_MD’s answer:

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

bri_stats said:

Senior perspective on cardiovascular risk: I'm 67 years old and started this journey skeptically.

I will push back on the "any working dose is fine" framing. The maintenance evidence sits overwhelmingly at the top studied dose, and the extension data shows regain tracking dose reduction rather than tracking stopping. Holding low is reasonable; pretending it is evidentially equivalent is not.

bri_stats said:

Senior perspective on cardiovascular risk: I'm 67 years old and started this journey skeptically.

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].

Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.

These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.

Reporting back.

Following this thread I went back and re-read the extension data properly. The point about trough rather than peak explains the pattern I was seeing on day six, which I had been blaming on the vial.