New obesity drug may aid in lowering blood pressure in adults

New research published today in the American Heart Association journal Hypertension reveals that the new weight loss drug, tripeptide, significantly reduced systolic blood pressure (the top number in a blood pressure reading) for almost 500 adults with obesity over about eight months. 

Systolic blood pressure is a better predictor of cardiovascular death than diastolic (the bottom number) blood pressure. According to the American Heart Association’s 2024 statistics, more than 122 million adults in the United States (about 47%) have high blood pressure, and almost 42% have obesity.

Tirzepatide is a medication that mimics two hormones: glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP). These hormones help regulate blood sugar levels, slow digestion, and reduce appetite, leading to weight loss. Tirzepatide stimulates insulin secretion and sensitivity after eating. 

It was approved by the FDA in 2022 for treating Type 2 diabetes and in late 2023 for managing chronic weight for people with obesity or overweight and at least one weight-related health condition. Unlike tripeptide, another medication called semaglutide only contains the GLP-1 hormone and does not have the GIP receptor agonist.

Lead study author James A. de Lemos, M.D., FAHA, the Kern Wildenthal, M.D., Ph.D., distinguished chair of cardiology and a professor of medicine at UT Southwestern Medical Center in Dallas said, “Our findings indicate treating obesity with the weight loss medication tirzepatide may be an effective strategy for preventing or treating high blood pressure.”

“Although tirzepatide has been studied as a weight loss medication, the blood pressure reduction in our patients in this study was impressive. While it is not known if the impact on blood pressure was due to the medication or the participants’ weight loss, the lower blood pressure measures seen with tirzepatide rivaled what is seen for many hypertension medications.” He added.

The study examined 600 people from the SURMOUNT-1 weight loss study to see if tirzepatide affects blood pressure. They didn’t have Type 2 diabetes but had obesity. Some got tirzepatide, some got a placebo. About one-third had high blood pressure and were on medication. At the start, everyone’s blood pressure was below 140/90 mm Hg. The study ran from December 2019 to April 2022.

Results after 36 weeks of taking tirzepatide:

• Those on 5 mg had an average drop of 7.4 mm Hg in systolic blood pressure.
• Those on 10 mg had an average drop of 10.6 mm Hg.
• Those on 15 mg had an average drop of 8.0 mm Hg.

These drops were seen both day and night. Nighttime blood pressure is more important for predicting heart problems. The drops were consistent across different groups by age, sex, weight, and other factors.

SURMOUNT-1 investigated tirzepatide’s impact on weight loss, finding that weekly injections of 5 mg, 10 mg, or 15 mg led to reductions of 15%, 19.5%, and 20.9%, respectively, compared to placebo, in higher weight or obese adult (BMI ≥27 kg/m²). The sub-study included 600 participants, with blood pressure data analyzed for 494 individuals with valid ambulatory monitoring data at the start of the study and at week 36. 

Requirements for inclusion in the analysis involved a minimum of 70% valid readings, with at least 20 daytime and seven nighttime lessons. Participants were predominantly female (69%), with an average age of 45.5 years and an average BMI of 37.4 kg/m², meeting obesity criteria. Ambulatory monitoring, conducted over 24-27 hours, recorded blood pressure every 30 minutes during the day and hourly at night, offering a more comprehensive assessment than office or daily home monitoring.

SURMOUNT-1 investigated tirzepatide’s impact on weight loss, finding that weekly injections of 5 mg, 10 mg, or 15 mg led to reductions of 15%, 19.5%, and 20.9%, respectively, compared to placebo, in higher weight or obese adult (BMI ≥27 kg/m²). The sub-study included 600 participants, with blood pressure data analyzed for 494 individuals with valid ambulatory monitoring data at the start of the study and at week 36. 

Requirements for inclusion in the analysis involved a minimum of 70% valid readings, with at least 20 daytime and seven nighttime lessons. Participants were predominantly female (69%), with an average age of 45.5 years and an average BMI of 37.4 kg/m², meeting obesity criteria. Ambulatory monitoring, conducted over 24-27 hours, recorded blood pressure every 30 minutes during the day and hourly at night, offering a more comprehensive assessment than office or daily home monitoring.

Michael E. Hall, M.D., M.S., FAHA, chair of the writing group for the Association’s 2021 scientific statement on weight-loss strategies for prevention and treatment of Hypertension and chair of the Department of Medicine at the University of Mississippi Medical Center in Jackson said, “Overall, these data are encouraging that novel weight-loss medications are effective at reducing body weight and they are also effective at improving many of the cardiometabolic complications of obesity including Hypertension, Type 2 diabetes and dyslipidemia, among others.”

While the impact of each of these beneficial effects is individually essential, many of these obesity-related complications act synergistically to increase the risk of cardiovascular disease. Thus, strategies that mitigate multiple obesity-related difficulties may reduce the risk of cardiovascular events.

The study highlights the promising role of the new weight loss medication in addressing obesity and high blood pressure in adults. If confirmed through additional research, this could offer a valuable therapeutic approach for managing cardiovascular risk factors associated with obesity.

Journal reference:

1. James A. de Lemos, Bruno Linetzky, et al., Tirzepatide Reduces 24-Hour Ambulatory Blood Pressure in Adults With Body Mass Index ≥27 kg/m2: SURMOUNT-1 Ambulatory Blood Pressure Monitoring Substudy. Hypertension. DOI:10.1161/HYPERTENSIONAHA.123.22022.