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Patients who have tolerated 10mg well and still have weight loss goals to achieve will progress here

Expired tirzepatide is unlikely to cause acute illness if it was stored properly and is only recently past its expiration date

Taken together, class effects on FMD/PWV plus tirzepatide's endothelial biomarker and haemodynamic profile support a model in which tirzepatide enhances vascular compliance indirectly (via weight loss, lower BP and reduced inflammation) and likely directly through endothelial pathways, thereby helping to reduce afterload and support diastolic filling pressures in HFpEF

The protective mechanism likely involves improved glycemic control without glycosuria

However, patients taking these medications should monitor for hypoglycemia symptoms if their tirzepatide dosing interval changes