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Hypertension

Weight loss from surgery or drug therapy reduces blood pressure

Nature Reviews Cardiology volume 21, page 218 (2024)Cite this article

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Two studies indicate that a reduction in body mass index (BMI) as a result of either bariatric surgery or pharmacological therapy is associated with a blood pressure-lowering effect.

In the randomized SURMOUNT-1 trial, the glucose-dependent insulinotropic polypeptide receptor (GIPR)–glucagon-like peptide 1 receptor (GLP1R) dual agonist tirzepatide was shown to reduce BMI and office blood pressure compared with placebo. The trial researchers conducted a substudy to investigate the effect of tirzepatide on 24-h ambulatory blood pressure in individuals with obesity but without type 2 diabetes mellitus. In the substudy, 600 patients receiving tirzepatide 5 mg, 10 mg or 15 mg or placebo underwent 24-h blood pressure monitoring at baseline and after 36 weeks. At baseline, the mean BMI was 37.4 kg/m2 and the 24-h systolic blood pressure was 124.6 mmHg, with no significant differences between the groups. At 36 weeks, treatment with each dose of tirzepatide reduced 24-h systolic blood pressure compared with placebo (–7.4 mmHg, –10.6 mmHg and –8.0 mmHg with 5 mg, 10 mg and 15 mg, respectively). The change in 24-h systolic blood pressure correlated with the change in body weight (r = 0.31, P < 0.0001). Although analyses suggested that tirzepatide-induced reductions in BMI were associated with the lowering of blood pressure, the GIPR–GLP1R dual agonist might also have effects on blood pressure that are independent of weight loss.

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  1. Nature Reviews Cardiology http://www.nature.com/nrcardio/

    Gregory B. Lim

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  1. Gregory B. Lim
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Correspondence to Gregory B. Lim.

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Lim, G.B. Weight loss from surgery or drug therapy reduces blood pressure. Nat Rev Cardiol 21, 218 (2024). https://doi.org/10.1038/s41569-024-01000-6

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