Arterial stiffness reduction on GLP-1 — July 2024

Dr.RheumBOS said:

Dizziness and cardiovascular risk: I was lightheaded for the first 2 weeks.

Dr.RheumBOS said:

...we're creating a generation dependent on cardiovascular risk...

I understand the concern, but consider this analogy: are we "creating a generation dependent on" blood pressure medication? Cholesterol medication? Thyroid medication?

Obesity is a chronic disease with biological drivers. Treating it with medication is no different from treating any other chronic condition. The "dependency" framing implies weakness or moral failure — neither of which is accurate.

If ongoing medication is what keeps someone healthy, that's successful treatment, not dependency.

A narrower follow-up, since the general answer is now clear:

What did you change at the same time, and can you separate the two now?

VendorMark said:

Dr.RheumBOS said: ...we're creating a generation dependent on cardiovascular risk...

Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history. Results were encouraging:

• NT-proBNP: 50 pg/mL (normal, cardiac function preserved)
• Lp(a): 60 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 140 to 90 mg/dL (excellent response)
• Coronary calcium score: 0 (unchanged from baseline — reassuring)

The ApoB reduction is particularly meaningful — it's considered the best single predictor of cardiovascular risk. GLP-1 therapy seems to improve this consistently.

VendorMark said:

Dr.RheumBOS said: ...we're creating a generation dependent on cardiovascular risk...

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

My doctor was initially hesitant because of my age, but the SELECT trial included patients up to 72 and showed consistent benefit across age groups. We started at the lowest dose with closer monitoring.

9 months later: down 46 lbs, off atorvastatin, A1C from 7.2% to 5.3%. My cardiologist is thrilled. cardiovascular risk is absolutely relevant for older adults — don't let anyone tell you otherwise.

MikeNYC_runner said:

Cardiac biomarkers and cardiovascular risk: my cardiologist ordered advanced cardiac labs given my family history.

Lp(a) and cardiovascular risk: a nuance that matters. Unlike most lipid markers, Lp(a) is 90%+ genetically determined and doesn't really change with weight loss or GLP-1 therapy.

My Lp(a) has remained at 76 nmol/L across all time points. If yours is elevated (>50 nmol/L), you need additional risk mitigation strategies regardless of your GLP-1 response. Don't assume your medication is covering all cardiovascular risk factors.