Arterial stiffness reduction on GLP-1 — 6 month update

DebRD_ATL said:

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

This is where I part company with the consensus forming above. 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.

CarlaRPh_TPA said:

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

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:

These NNTs are clinically meaningful and comparable to accepted cardiovascular interventions.

DanielChem_CHI said:

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

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 41 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.

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?

andrew_nyc said:

Lp(a) and cardiovascular risk: a nuance that matters.

Metabolic syndrome resolution on cardiovascular risk: I went from meeting 3 of 5 diagnostic criteria to meeting ZERO after 14 months of treatment.

The 5 criteria (and my journey):

1. Waist circumference: 53" → 35" ✅ Resolved
2. Triglycerides: 261 → 96 ✅ Resolved
3. HDL: 37 → 53 ✅ Resolved
4. Blood pressure: 141/95 → 119/73 ✅ Resolved
5. Fasting glucose: 126 → 89 ✅ Resolved

Metabolic syndrome reversal is, in my view, the most medically significant outcome of GLP-1 therapy.