Echocardiographic changes on GLP-1 — LV mass and diastolic function

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…

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off amlodipine entirely! My cardiologist is thrilled.

If you're on BP meds and losing weight on a GLP-1, monitor your BP at home regularly. Hypotension symptoms (dizziness, lightheadedness when standing) mean your BP meds may need reduction. Don't wait for your next scheduled appointment — call your doctor.

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…

Pushing back on Dr.CardioMD here. 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.

Dr.SurgeonPGH said:

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

Dr.SurgeonPGH 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.

PurityPaulOR said:

Positive "side effect" of cardiovascular risk: my blood pressure dropped so much that I'm now off amlodipine entirely!

Can confirm. Same sequence, different timescale. The detail I would add is minor and it is already implied above.