Abstract 4141117: Semaglutide and cardiovascular outcomes by blood pressure in the SELECT trial
Bibliographic record
Abstract
Introduction: Although glucagon-like peptide-1 receptor agonists have been shown to reduce BP and major cardiovascular adverse events (MACE), little is known about whether the benefits of these therapies vary in individuals with hypertension (HT) or across the spectrum of BP categories. Research Question and Aim: To evaluate the effect of once-weekly semaglutide 2.4 mg vs placebo on cardiovascular (CV) outcomes by baseline BP categories in SELECT. Methods: SELECT was a double-blind, randomized, placebo-controlled trial that included patients aged ≥45 years with preexisting CV disease and BMI ≥27 kg/m 2 without diabetes. Patients received once-weekly semaglutide 2.4 mg or placebo; the primary endpoint was time to first MACE analyzed with a Cox proportional hazards model with semaglutide and placebo as fixed factors according to baseline BP categories. Results: Among 17,604 randomized patients, 14,392 (82%) had a history of HT. Patients with history of HT were older and more likely female, with a higher BMI, lower eGFR, and higher UACR. A higher proportion presented with atrial fibrillation, obstructive sleep apnea, and heart failure NYHA class II/III, but fewer underwent coronary revascularization (Table). Patients with HT who received placebo had a higher incidence rate of MACE vs semaglutide (2.6 vs 2.1 per 100 patient-years, respectively). Semaglutide generally exhibited consistent benefits for CV outcomes regardless of history of HT or baseline BP categories (Figure). Compared with placebo, semaglutide significantly and consistently reduced systolic BP (SBP) across BP categories (normal, −2.9 [95% CI−4.0; −1.9]; elevated BP, −2.8 [−4.0; −1.6]; stage 1, −3.4: [−4.1; −2.6]; stage 2, −3.7 [− 4.4; −2.9]). Conclusions: HT is highly prevalent in people with overweight or obesity and atherosclerotic CV disease without diabetes and is associated with increased MACE. Semaglutide led to consistent reductions in MACE and lowered SBP irrespective of baseline BP category.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".