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The primary mechanisms underlying these effects include enhanced endothelial function, protection of the endothelium from intracellular reactive oxygen species production, increased nitric oxide (NO) bioavailability, reduction of microvascular dysfunction and a reduction of insulin resistance and both visceral and subcutaneous adipose tissue

Clinical trial data from the SURPASS program show that tirzepatide produces small, statistically significant increases in resting heart rate compared to placebo

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