What questions should I ask my cardiologist about GLP-1 drugs?

Five specific questions that advance the clinical conversation beyond "is this drug right for me?": First, "Do I fit the SELECT trial criteria?" (adults 45+, BMI 27+, established CVD, no type 2 diabetes). Knowing your trial-matching profile determines the strength of the evidence applicable to you. Second, "What is my current hs-CRP and ApoB, and are these the biomarkers we'll track to assess drug response?" These are the metrics most likely to show measurable change at six months. Third, "Given my blood pressure medications, what monitoring schedule do you recommend during dose escalation?" Proactive blood pressure monitoring avoids discovering hypotension through symptoms. Fourth, "Should my antihypertensive doses be reviewed as I lose weight?" Some patients on multiple agents require dose reduction as blood pressure improves on semaglutide. Fifth, "What protein and exercise protocol should I maintain to preserve muscle mass?"

A cardiologist who gives specific numerical answers to these questions is engaged with the current evidence base. Generic answers or dismissal of these questions is a signal that the conversation needs to continue elsewhere. Bring the SELECT trial saved on your phone. It is 17,604 patients and three years of rigorous follow-up. You are entitled to a discussion informed by that evidence. (Lincoff et al., NEJM, 2023)

Cardiologist's calibrated position, Solid (1) for this question framework as a basis for an evidence-informed clinical conversation.

What to do: Print or save these five questions before your appointment. A 15-minute appointment spent on the right questions is more valuable than a 45-minute appointment spent on the wrong ones.

For the full picture, read The Drug That Surprised Cardiologists.