Arterial stiffness reduction on GLP-1 — need advice

tony_orlando 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…

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, -2.3 lbs/week average
Fasting glucose (finger stick): stable at 86 mg/dL
Blood pressure (home): 118/72 average
Resting heart rate: 66 bpm (down from 82)
Waist circumference: down 16 inches total

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

tony_orlando 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…

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.

That is the short version; the long version is somebody else's post.

amsterdam_pete said:

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

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.

HPLC_Greg said:

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

Can confirm. Same sequence, different timescale. I had assumed I was the exception until I read this.