Has anyone dealt with semaglutide cardiovascular benefit: select trial deep dive?

Taking the question as asked, rather than the general version of it. The dose-response is real but shallow at the top. Across STEP 1 and STEP 4 the gap between 1.7mg and 2.4mg is a couple of percentage points of body weight on average, and the average is carrying a wide spread — plenty of people at 1.7mg sit above the 2.4mg mean. If a dose is working and tolerable, "working" is the relevant variable, not "maximal".

LarryQC_SD said:

The dose-response is real but shallow at the top.

Agreed, though "tolerable" needs defining. A dose you tolerate by eating almost nothing is not tolerated, it is being paid for somewhere else — usually in lean mass, sometimes in adherence three months later.

newstart_MO said:

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

That holds for the injectable. The oral formulation has different absorption behaviour and the dose numbers are not interchangeable, which is worth saying out loud because people quote them as if they were.

From the other side of the consultation, briefly.

Continuous metabolic monitoring dashboard for cardiovascular risk — I track everything in a spreadsheet and here's the month-over-month trend for my key markers:

Weight: consistent downtrend, -2.2 lbs/week average
Fasting glucose (finger stick): stable at 83 mg/dL
Blood pressure (home): 117/73 average
Resting heart rate: 63 bpm (down from 79)
Waist circumference: down 13 inches total

The resting heart rate improvement correlates with cardiovascular fitness gains. Everything is moving in the right direction.