VendorMark said:I want to bring up the cardiovascular angle on cardiovascular risk.
Anti-inflammatory mechanisms of GLP-1 agonists and cardiovascular risk: beyond weight loss, GLP-1R activation directly suppresses NF-κB signaling, reduces NLRP3 inflammasome activation, and decreases monocyte/macrophage adhesion to endothelium[1].
Clinical correlates: hsCRP reduction of 30-60% (consistently seen across trials), reduced carotid intima-media thickness, and decreased coronary plaque inflammation on PET imaging.
These anti-inflammatory effects likely contribute to the cardiovascular benefit seen in SELECT — and may explain benefits beyond what weight loss alone would predict.
[1] Hogan AE, et al. Diabetologia. 2014;57(4):781-784.
josh_phd_bmore said:I'm 55 years old and want to share my perspective on cardiovascular risk as an older member of this community.
Genuinely useful, thank you. I had the facts and not the framework. Sending this to two other people who asked me the same thing last week.
VendorMark said:I want to bring up the cardiovascular angle on cardiovascular risk.
6 month update on cardiovascular risk: down 40 lbs, off blood pressure meds, A1C normalized. Genuinely life-changing.
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View Resultsjames_edin said:Prescribed on cardiovascular grounds rather than for weight, and almost everything written for patients assumes the opposite.
Mendelian randomization evidence supporting GLP-1 pathway modulation for cardiovascular risk: genetic variants in the GLP1R gene region associated with lower BMI also show associations with reduced cardiovascular risk, confirming a causal pathway[1].
This "natural experiment" (people born with genetically higher GLP-1 signaling being leaner and healthier) provides orthogonal evidence supporting the pharmacological approach. When genetic epidemiology, clinical trials, and mechanistic studies all converge, confidence in the therapeutic approach is high.
[1] Zheng SL, et al. Lancet Diabetes Endocrinol. 2023;11(12):869-879.
Moderator note: a couple of off-topic posts removed. Thread quality here is what the rules are for. Keep it up.