Weight loss drug helps
significantly lower blood pressure in adults who are overweight or obese, study
finds
The drug tirzepatide — sold
under the brand names Zepbound for obesity and Mounjaro for diabetes —
significantly lowered the blood pressure of adults with overweight or obesity
who took it for nine months, according to a new study.
This research, published
Monday in the American Heart Association journal Hypertension, is part of
a larger clinical trial that previously showed that
weekly tirzepatide injections resulted in weight loss of up to 22% in adults
with overweight or obesity, helping prompt the US Food and Drug Administration
to approvethe drug for chronic weight management in November. The research was
funded by the drug’s maker, Eli Lilly.
To assess the effect of tirzepatide on blood pressure, the
researchers enrolled 600 adults from the original clinical trial who had a body
mass index of 27 or more, who did not have type 2 diabetes and who had either
normal blood pressure or high blood pressure that was under control. The
participants had their blood pressure monitored for a day before beginning
treatment and again after nine months of weekly tirzepatide injections.
The results showed a significant decrease in the
participants’ systolic blood pressure, the top number in blood pressure
readings, which is a strong predictor of heart disease.
Participants
taking 5 milligrams of tirzepatide weekly had an average reduction in systolic
blood pressure of 7.4 mmHg, those on 10 milligrams had an average reduction of
10.6 mmHg, and those on 15 milligrams had an average reduction of 8.0 mmHg.
“An eight-point
difference is really an impressive effect that rivals or exceeds many of our
usual blood pressure medications,” said Dr. Harlan Krumholz, a cardiologist at
Yale University who was not involved with the research.
The real effect of tirzepatide on blood pressure may be
even more pronounced, given that most of the study participants did not have
high blood pressure to begin with, said Dr. Michael E. Hall, chair of the
Department of Medicine at the University of Mississippi Medical Center, who was
not involved with this study.
Tirzepatide works by mimicking the action of two different gut hormones. When blood sugar rises after eating, the drug stimulates the body to produce more insulin, which lowers blood sugar. It also slows the movement of food from the stomach, making people feel fuller for longer. It works similarly to semaglutide, the active compound in the weight loss drug Wegovy and its sister diabetes drug, Ozempic. Wegovy was shown to reduce the risk of heart attack, stroke or heart-related death in people who h ad heart disease and obesity or overweight by 20% in a study last summer.
As for the new
study, it’s not clear whether the significant reduction in blood pressure was
due to the participants’ weight loss in the larger study or the medication. The
study also did not account for participants’ dietary intake, which could play a
role in the results
Additional
studies will be needed to determine tirzepatide’s effect on direct
cardiovascular conditions like heart attack and heart failure and to assess
whether the blood pressure changes reverse after people stop taking the drug,
said Hall, who also chaired the writing group for the American Heart
Association’s 2021 scientific
statement on weight loss and hypertension, in a
news release.
“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,” he said.
More than 47% of adults in the United States have
hypertension, defined as blood pressure over 140/90 mmHg, and nearly 42% of
adults have obesity, according to the AHA’s2024 Heart Disease and Stroke Statistics. These diseases are closely
linked, as obesity is the main cause of high blood pressure; about 75% of
hypertension can be attributed to obesity, according to the AmericanHeart Association. And high blood pressure is a major risk factor for heart
diseases like coronary artery disease and stroke.
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“By treating
one disease, obesity, we can potentially mitigate hundreds of other
obesity-related conditions, including hypertension,” Dr. Ania Jastreboff,
director of the Yale Obesity Research Center, who helped conduct the larger
weight loss trial, wrote in an email.
Although there
are effective blood pressure medications available, only about a quarter of
people with hypertension have adequately controlled blood pressure, Hall said.
This is often because people don’t take their medications. Finding a way to
simplify and combine treatment for these diseases would make life much easier
for both patients and doctors, Hall added.
Krumholz said that although much of the hype around
tirzepatide has focused on its weight loss effects, the real health benefits
lie downstream: weight loss leading to reduced blood pressure and increased
ability to exercise, leading to improved heart health. He views the weight loss
effect of the drug as a pleasant side effect that will make people more likely
to take their medication.
Before
the development of tirzepatide and similar obesity drugs, lifestyle
modifications were the main way to treat obesity, Krumholz said. Though these are also
beneficial, a healthy diet and more exercise often aren’t enough to combat the
disease of obesity and our bodies’ evolutionary tendency to try to regain
weight, he added.
“Patients would end up feeling bad about
themselves and frustrated and guilty,” he said. “These [drugs] represent almost
a miracle. [People] can now take a medication that not only helps them lose
weight but can improve their health.”
However, the
cost of these new weight loss medications and insufficient insurance coverage
keeps many eligible people from accessing them, Krumholz said. He warned that
unless these barriers are addressed, these new treatments could instead
contribute to worsening health disparities in the US.
Courtesy: CNN’s Meg Tirrell
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