Tirzepatide lowers blood pressure through weight loss

Treatment with tirzepatide appears to confer reductions in blood pressure (BP) levels among individuals with obesity or overweight, with weight loss being the primary driver of this BP-lowering benefit, according to a post hoc analysis of the SURMOUNT-1 trial.

SURMOUNT-1 was a 72-week trial wherein tirzepatide was evaluated in the treatment of people with obesity or overweight with weight-related complications. Researchers performed post hoc analyses to further explore the effects of tirzepatide on the pattern of BP reduction and whether the effects were consistent across various subgroups.

Mixed models for repeated measures were used to analyse changes in overall BP levels across demographic and clinical subgroups, baseline BP subgroups, and hypertension categories between SURMOUNT-1 participants who received tirzepatide and their counterparts who received placebo. Mediation analysis was performed to assess the association between weight changes and BP and adverse events associated with low BP.

The tirzepatide group showed a rapid decline in systolic and diastolic BP over the first 24 weeks, followed by BP stabilization until the end of the observation period. This corresponded to a significant net reduction of 6.8 mm Hg systolic and 4.2 mm Hg diastolic BP at 72 weeks relative to placebo.

Participants on tirzepatide were more likely to have normal BP levels at week 72 compared with those on placebo (58.0 percent vs 35.2 percent, respectively). The effects were broadly similar across baseline BP subgroups.

Results of the mediation analysis indicated that weight loss accounted for 68 percent of the systolic and 71 percent of the diastolic BP improvement.

Low BP adverse events occurred infrequently, although the rate was higher in the tirzepatide group.