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And in short that came out a few years after that STEP 1 trial what we did for the very first time is take individuals with obesity and pre-existing cardiovascular disease, like a prior stroke, prior heart attack, or peripheral arterial disease, called PAD, and they're on maximal therapy for their cardiovascular disease or stroke, and then randomized them on top of that to either semaglutide or placebo

One key factor in this process is the natural decrease in growth hormone production by the pituitary gland as we age