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[4] [6] Medication review: A thorough review of concomitant medicines that may independently raise heart rate is advisable, including sympathomimetics, SNRIs, tricyclic antidepressants, and beta-2 agonists Lifestyle measures: Reducing caffeine intake, managing stress, and ensuring adequate sleep can all contribute to heart rate regulation Cardiac monitoring: In patients with pre-existing cardiac conditions, an electrocardiogram (ECG) or ambulatory heart rate monitoring may be warranted Specialist referral: If tachycardia persists or is associated with arrhythmia, referral to a cardiologist should be considered In some cases, if the heart rate elevation is persistent and symptomatic despite dose adjustment, discontinuation of retatrutide may be necessary

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The primary endpoint is the time to the first occurrence of a composite primary outcome event, defined as a persistent eGFR decline (50% from baseline), reaching ESRD, renal death, or CV death

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