Should I be worried about my heart rate going up? — what worked for you?

LabKate said:

Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling,…

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.

If somebody has the primary source to hand I would rather cite it than paraphrase it.

BiostatsBrad said:

Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

SUSTAIN-6 was the first CVOT to show cardiovascular benefit with semaglutide, relevant to cardiovascular risk. In 3,297 T2DM patients with high CV risk: MACE HR 0.74 (95% CI 0.58-0.95, p=0.02)[1].

Notable: the retinopathy signal in SUSTAIN-6 (HR 1.76) was subsequently attributed to rapid A1C reduction in patients with pre-existing retinopathy — not a direct drug effect. This has been confirmed in longer-term follow-up studies.

Dr.KarenChen said:

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

Dr.KarenChen 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?

Dr.DermMIA said:

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

Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:

Weight: consistent downtrend, -1.9 lbs/week average
Fasting glucose (finger stick): stable at 88 mg/dL
Blood pressure (home): 119/74 average
Resting heart rate: 68 bpm (down from 84)
Waist circumference: down 18 inches total

The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.