Semaglutide effective as add on therapy for patients with hypertension and obesity, finds research

A new study published in the European Heart Journal showed that semaglutide is a helpful additional medication for the individuals who are obese and have high blood pressure.

Even with the availability of efficient medicines, meeting blood pressure objectives is difficult and poses a serious threat to world health. There are several ways in which obesity and hypertension interact. The processes most likely include changes in how the body handles salt, an inflammatory environment, and activation of the sympathetic nervous system. Treatments for hypertension now available focus on pathways that interact with the ones impacted by being overweight. But addressing the obesity illness could be a useful tactic to manage blood pressure, especially for the ones with resistant hypertension (RH). Thereby, determining the impact of semaglutide therapy on systolic BP (SBP) among individuals with hypertension, SBP in individuals with RH, SBP while baseline body mass index (BMI) is taken into account, and modifications to anti-hypertensive drugs were among the objectives of this study.

Individual patient data (IPD) from 3 RCTs that looked at how semaglutide 2.4 mg affected body weight over a 68-week period was included. The trial participants were divided into 3 groups based on the hypertension diagnosis, where the one group had apparent resistant hypertension (RH), other group with baseline SBP > 130 mmHg (HTN130) or > 140 mmHg (HTN140) and the last group was treatment or baseline measurement (HTN). The main comparison was between the semaglutide and placebo groups' in-trial changes in SBP. Treatment intensity score was used to quantify and compare changes in antihypertensive medication across groups. Analysis of covariance was used in these analyses.

The study found that there was a difference in SBP change of −4.95 mmHg between the treatment (n = 2109) and placebo (n = 1027) groups. The HTN, HTN130, HTN140, and RH had the largest differences, with −4.78 mmHg (95% CI −5.97 to −3.59), −4.93 mmHg, and −4.09 mmHg for HTN140, respectively. Weight loss was a major mediating factor in the reduction in SBP. The anti-hypertensive therapy intensity score dropped for semaglutide users when compared to placebo. Overall, the outcome of this analysis showed a drop in SBP that was equivalent in persons with normotension and hypertension. The weight loss impact of semaglutide acted as a mediator for the decrease in SBP.

Reference:

Kennedy, C., Hayes, P., Cicero, A. F. G., Dobner, S., Le Roux, C. W., McEvoy, J. W., Zgaga, L., & Hennessy, M. (2024). Semaglutide and blood pressure: an individual patient data meta-analysis. In European Heart Journal. Oxford University Press (OUP). https://doi.org/10.1093/eurheartj/ehae564