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Abbreviations AHA: American Heart Association ASCVD: Atherosclerotic cardiovascular disease CI: Confidence interval CMA: A conventional meta-analysis CVD: Cardiovascular disease EASD: European Association for the Study of Diabetes ESC: European Society of Cardiology FPG: Fasting plasma glucose GLP-1RA: Glucagon-like peptide-1 receptor agonists HbA1c: Hemoglobin A1c LVEF: Left ventricular ejection fraction MACE: Major adverse cardiovascular events MD: Mean difference PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses QALY: Quality-adjusted life year RCT: Randomized controlled trial RIS: Required information size RoB2: Risk of bias tool for randomized trials RR: Risk ratio SD: Standard deviation SE: Standard error SGTL-2i: Sodium-glucose co-transporter-2 inhibitors T2DM: Type 2 diabetes mellitus TAU: Treatment as usual TSA: Trial sequential analysis UTI: Urinary tract infection References Low Wang CC, Hess CN, Hiatt WR, Goldfine AB

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Controlled substances may not be appropriate for all patients and any mention of these medications is for educational purposes only, not for marketing or encouraging self-diagnosis

3 Results 3.1 Chemical characterization of HnB mainstream HnB mainstream was characterized using GC-MS, which revealed the presence of aldehydes (e.g., formaldehyde, acetaldehyde) and polycyclic aromatic hydrocarbons (PAHs) (Table 2)

Planning Treatment Breaks Before Conception Most reproductive endocrinologists recommend stopping GLP-1 therapy at least one to three months before attempting pregnancy to allow medication clearance and restoration of normal appetite and glucose regulation

Tier 2: A BMI of 30 or higher, plus at least one comorbid condition such as heart failure, uncontrolled high blood pressure, or chronic kidney disease