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Those who may warrant closer monitoring include: Individuals with pre-existing tachycardia or arrhythmias, such as atrial fibrillation or supraventricular tachycardia Patients with hyperthyroidism, which independently elevates resting heart rate Those taking other medicines that may increase heart rate, including sympathomimetics (such as decongestants and stimulants), serotoninnoradrenaline reuptake inhibitors (SNRIs), tricyclic antidepressants, or beta-2 agonists used in asthma management Individuals with a history of heart failure, where even modest increases in heart rate may affect cardiac output and symptom burden though it should be noted that increased cardiovascular risk in this group is based on clinical prudence rather than confirmed harm with GLP-1 receptor agonists Patients receiving higher doses of retatrutide, given the dose-dependent nature of the effect observed in Phase 2 trials Age and baseline cardiovascular health are also relevant considerations