# Cardiovascular and kidney trials

> Semaglutide Texas: cardiovascular and kidney trials — Semaglutide Texas examines SELECT, FLOW and STEP-HFpEF: distinct populations, serious health events, symptoms and physical limitations.

These trials move the conversation beyond body weight. Their populations deserve the same attention as their results.

## SELECT and cardiovascular events

In [SELECT, 17,604 adults had established cardiovascular disease and overweight or obesity, without diabetes](https://pubmed.ncbi.nlm.nih.gov/37952131/). Once-weekly semaglutide 2.4 mg reduced major adverse cardiovascular events versus placebo: hazard ratio 0.80, with a 95% confidence interval of 0.72–0.90. The reported relative risk reduction was 20%.

The endpoint was a composite, meaning the trial counted several specified outcomes together: cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Myocardial infarction is the medical term for a heart attack. The reduction applies to the combined endpoint.

For sheer consequence, SELECT outranks a flattering account of appearance in my estimation. That preference reflects the importance of serious health events. The evidence itself concerns people who already had cardiovascular disease, and that qualification limits how far I can carry it.

## FLOW and major kidney-disease events

[FLOW enrolled 3,533 people with type 2 diabetes and chronic kidney disease](https://pubmed.ncbi.nlm.nih.gov/38785209/). Its semaglutide group received 1.0 mg once weekly. Major kidney-disease events were reduced compared with placebo, with a hazard ratio of 0.76 and a 95% confidence interval of 0.66–0.88, reported as a 24% lower risk.

This endpoint combined kidney failure, a decline of at least 50% in eGFR, or kidney or cardiovascular death. eGFR is an estimate of kidney filtration. The combination makes this a broader outcome than a single laboratory value.

Major disease events give this research real heft for me. But I can't carry a result from people with diabetes and chronic kidney disease into a claim about protecting every healthy kidney. The population names the terrain actually covered.

## STEP-HFpEF and daily limitations

[STEP-HFpEF studied people with obesity-related heart failure with preserved ejection fraction](https://pubmed.ncbi.nlm.nih.gov/37622681/). Semaglutide 2.4 mg once weekly improved heart-failure-related symptoms and physical limitations and produced greater weight loss than placebo. The reported symptom and physical-limitation measure was the KCCQ score.

Symptoms and physical limitations pull my interest in another direction: toward how life feels and what a person can manage. I appreciate seeing that question measured alongside weight. This trial's finding concerns this form of heart failure with obesity; SELECT's event result answers a different question.

Read together, the studies expand the subject while preserving its boundaries. For a fuller account of treatment burden, continue to [side effects in the trials](/side-effects), including the retinal finding in a separate diabetes population.

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Semaglutide Texas is my editorial folio of published research; it operates no business and offers no medical advice.