Has anyone dealt with glp-1 and peripheral arterial disease?

Dr.EM_Chicago said:

Dr.NateNeph said: ...we don't know the long-term effects of cardiovascular risk...

Dr.EM_Chicago 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.

bri_stats said:

I'm 58 years old and want to share my perspective on cardiovascular risk as an older member of this community.

Bookmarking. The distinction being drawn above is the one nobody else makes.

Dr.EM_Chicago said:

Dr.NateNeph said: ...we don't know the long-term effects of cardiovascular risk...

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

• NT-proBNP: 70 pg/mL (normal, cardiac function preserved)
• Lp(a): 30 nmol/L (genetic, unchanged — expected)
• ApoB: dropped from 135 to 95 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.

traveltech_sara said:

My reason for being on this is cardiovascular rather than cosmetic, which puts me in a small minority in most of these threads.

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.

Moderator note: leaving this open. It is being argued well and the disagreement is the useful part. No action needed from anybody.