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While the semaglutide CVOTs did not show an increased incidence of hospitalization for HF compared to placebo (101), in earlier smaller studies with liraglutide in patients with HF with reduced left ventricular ejection fraction, the GLP-1RA was associated with increased incidence of serious cardiac events (rhythm disorders, worsening of HF) (102, 103)

Consequently, the potency, purity, and effectiveness of these drugs may vary, potentially leading to unpredictable health outcomes for patients

To be fair, their thinking has merit

You might be recommended the 1mg dose if the 0.5mg dose hasnt worked well enough at controlling your blood sugar