SELECT trial 4-year follow-up data released — sustained MACE reduction

newstart_MO said:

Relative and absolute effects need reading together.

Thank you — that is the clearest version of this I have read, and I have read a lot of them. I will report back once I have actually tried it.

From the other side of the consultation, briefly.

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 70 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.

Dr.SleepRoch said:

The gap between trial results and real-world results is consistent and it is not fraud.

I read this differently from Dr.SleepRoch, on substance rather than tone. I would add the less popular caveat: these trial populations under-represented several groups, older adults and the highest BMI categories among them. The results probably generalise, and "probably" should be stated as an assumption rather than dropped.

Dr.CardioMD said:

SELECT is the trial that changed the framing of this class, because it was an outcome trial rather than a weight trial: about a 20% relative reduction…

Senior perspective on cardiovascular risk: I'm 69 years old and started this journey skeptically. My geriatrician recommended it after years of failed interventions.

13 months later: down 42 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.

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again.