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ForumsCardiovascular OutcomesBlood pressure went from scary to perfect - anyone else? — anyone have experience? Page 2

Blood pressure went from scary to perfect - anyone else? — anyone have experience?

SallyK_inj Mon, Jul 21, 2025 at 4:58 AM 9 replies 1,317 viewsPage 2 of 2
Dr.NutriCornell
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Jul 21, 2025 at 8:08 AM#6
DanielChem_CHI said:
SallyK_inj said: ...cardiovascular risk is just another fad...

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.

3 6emily_PDX, Dr.SleepRoch, laura_annarbor
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lisa_labSD
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San Diego, CA
Jul 21, 2025 at 9:22 AM#7
SallyK_inj said:
Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.

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

9 months later: down 52 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.

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Dr.EndoIndy
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Indianapolis, IN
Jul 21, 2025 at 10:36 AM#8
Dr.NutriCornell said:
The "earlier than weight loss explains" argument is weaker than this thread makes it sound.

CRP reduction on cardiovascular risk — this is the lab result that excites me most:

Baseline hsCRP: 11.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 1.5 mg/L (moderate risk)
Month 12 hsCRP: 0.5 mg/L (low risk)

This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 18% to 4%. My cardiologist is genuinely impressed.

Last edited: Jul 21, 2025 at 1:36 PM
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quinn_sf
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Jul 21, 2025 at 11:50 AM#9

A narrower follow-up, since the general answer is now clear:

Did your prescriber agree with that reading, and if not what was their objection?

Last edited: Jul 21, 2025 at 5:50 PM
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SallyK_inj
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Jul 21, 2025 at 5:45 PM#10
Dr.EndoIndy said:
CRP reduction on cardiovascular risk — this is the lab result that excites me most: Baseline hsCRP: 11.0 mg/L (high cardiovascular risk) Month 6…

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.

References:
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
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