References Prisant, L
Primary outcome (major adverse cardiovascular events) occurred in 12.0 percent of the semaglutide group versus 13.8 percent with placebo This corresponds to a 14 percent relative reduction in risk Absolute reduction in risk was 2.0 percent over 3 years Number needed to treat to prevent one event: 50 patients Nonfatal heart attacks occurred in 4.0 percent with semaglutide versus 5.2 percent with placebo Stroke and death from cardiovascular causes were slightly lower but not statistically different Kidney outcomes were directionally better with semaglutide but not statistically significant Additional benefits with oral semaglutide Lower average blood sugar (hemoglobin A1c reduced by 0.71 percent vs
1 Both are once-a-week injections with a similar dose schedule
It's worth noting that NICE guidance (NG28) advises against combining GLP-1 receptor agonists with DPP-4 inhibitors
Mechanisms hypothesised to underlie blood pressure reduction with tirzepatide include: Weight reduction : Loss of adipose tissue decreases sympathetic nervous system activity, reduces cardiac output, and improves insulin sensitivityall contributing to lower blood pressure Natriuresis : GLP-1 receptor activation may promote sodium excretion through renal effects, though direct evidence for tirzepatide is limited Improved endothelial function : Weight loss and metabolic improvements may enhance vascular health Reduced inflammation : Adipose tissue reduction decreases pro-inflammatory cytokines that may contribute to hypertension It is important to note that whilst the blood pressure reductions are consistent across trials, tirzepatide is not licensed as an antihypertensive agent
found that all BS types resulted in similar rates of vitamin D, calcium, iron, vitamin A, and vitamin B12 deficiencies at 24 months postoperatively [69]