NNT for MACE prevention — 6 month update

Dr.SleepRoch said:

6 month update on cardiovascular risk: down 46 lbs, off blood pressure meds, A1C normalized.

Pushing back on Dr.SleepRoch 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.

MikeNYC_runner said:

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

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

• NT-proBNP: 58 pg/mL (normal, cardiac function preserved)
• Lp(a): 58 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 143 to 98 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.

LibrarianMeg said:

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

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 56 lbs, off lisinopril, A1C from 7.2% to 5.5%. My cardiologist is thrilled. cardiovascular risk is absolutely relevant for older adults — don't let anyone tell you otherwise.

Following on from EndoResFellow — and this may be the naive question:

How long did you give it before you decided it was working?

Dr.BariatricHTX said:

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

Dizziness and cardiovascular risk: I was lightheaded for the first 3 weeks. Root cause was a combination of reduced caloric intake and mild dehydration.

Fix: minimum 80-100oz water daily, don't skip meals even if you're not hungry (eat small protein-rich snacks), and stand up slowly from sitting/lying positions. Also check your blood pressure — GLP-1-induced weight loss can make BP meds too strong, requiring dose reduction.