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Every enrolled patient already had vascular disease. Whether semaglutide reduces first cardiovascular events in lower-risk people with overweight or obesity is not what SELECT tested, and pretending otherwise overstates what we know. The risk-reduction figures often quoted from the SURMOUNT-5 analysis are based on the Framingham risk equations applied to changes in risk factors they are modelled, not observed. Useful as a hypothesis

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This dangerous combination can rapidly precipitate acute heart failure, fatal pulmonary edema, cardiac arrest, and death (Ebert 2026, Medical Advisory Board 2026a, Medical Advisory Board 2026b)

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