From the other side of the consultation, briefly.
Senior perspective on cardiovascular risk: I'm 64 years old and started this journey skeptically. My internist recommended it after years of failed interventions.
12 months later: down 42 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.
Following on from marcus_mpls — and this may be the naive question:
How would you tell the difference between that and the alternative explanation?
james_edin said:Senior perspective on cardiovascular risk: I'm 64 years old and started this journey skeptically.
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.
[1] Marso SP, et al. N Engl J Med. 2016;375(19):1834-1844.
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Browse GL Biochemjames_edin said:Senior perspective on cardiovascular risk: I'm 64 years old and started this journey skeptically.
CRP reduction on cardiovascular risk — this is the lab result that excites me most:
Baseline hsCRP: 12.0 mg/L (high cardiovascular risk)
Month 6 hsCRP: 1.5 mg/L (moderate risk)
Month 12 hsCRP: 0.7 mg/L (low risk)
This level of inflammatory marker reduction is comparable to what you'd see with statin therapy. Combined with the weight loss, my 10-year ASCVD risk score dropped from 19% to 4%. My cardiologist is genuinely impressed.