Dr.GutHealth said:I want to bring up the cardiovascular angle on cardiovascular risk.
Thank you for spelling out the reasoning rather than just the conclusion.
Adding the clinical framing, because it changes how the question reads.
Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically. My geriatrician recommended it after years of failed interventions.
9 months later: down 48 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.
Dr.PeteFamMed said:Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically.
This matches mine closely enough to be worth saying so out loud. The detail I would add is minor and it is already implied above.
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View ResultsDr.PeteFamMed said:Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically.
NNT calculation for cardiovascular risk clinical endpoints: NNT = 1/ARR (absolute risk reduction).
From SELECT trial: MACE at 39 months — 6.5% semaglutide vs 8.0% placebo. ARR = 1.5%. NNT = 67 over 3.3 years.
Compare to established therapies:
| Intervention | NNT | Timeframe |
|---|---|---|
| Semaglutide (MACE) | 67 | 3.3 years |
| Statins primary prevention (MI) | ~100 | 5 years |
| Aspirin secondary prevention | ~77 | 2 years |
These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.
Dr.PeteFamMed said:Senior perspective on cardiovascular risk: I'm 65 years old and started this journey skeptically.
Lp(a) and cardiovascular risk: a nuance that matters. Unlike most lipid markers, Lp(a) is 90%+ genetically determined and doesn't really change with weight loss or GLP-1 therapy.
My Lp(a) has remained at 43 nmol/L across all time points. If yours is elevated (>50 nmol/L), you need additional risk mitigation strategies regardless of your GLP-1 response. Don't assume your medication is covering all cardiovascular risk factors.