Semaglutide reduced systolic blood pressure by about 5 mmHg compared to placebo, with the effect largely driven by weight loss.
-4.95 mmHgAverage systolic blood pressure reduction with semaglutide vs. placebo across 3,136 participants
What the researchers found
Across 3,136 participants from three randomized controlled trials, semaglutide 2.4 mg produced an overall systolic blood pressure reduction of -4.95 mmHg (95% CI -5.86 to -4.05) compared to placebo over 68 weeks.
Importantly, the blood pressure reductions in people with hypertension (-4.78 mmHg) were similar to the overall population, rather than being larger as the researchers hypothesized. Those on semaglutide also reduced their anti-hypertensive medication intensity compared to placebo (score difference -0.51), suggesting that some of the blood pressure benefit may have been masked by concurrent medication reductions.
Why it matters
Semaglutide is already widely used for weight management and diabetes, so understanding its blood pressure effects has major implications. This analysis shows it offers meaningful blood pressure reduction as a bonus benefit, potentially allowing patients to simplify their medication regimens by reducing anti-hypertensive drugs.
How the study worked
The researchers conducted an individual patient data meta-analysis, pooling raw data from 3,136 participants across three large randomized controlled trials of semaglutide 2.4 mg vs. placebo over 68 weeks. Participants were grouped by hypertension status using several definitions, and blood pressure changes were compared using statistical models that adjusted for baseline differences.
What this study cannot tell us
The blood pressure reductions in people with hypertension were not statistically significantly greater than in the overall population, partly because concurrent reductions in blood pressure medications may have blunted the observed effect. The study also only examined semaglutide 2.4 mg over 68 weeks, so effects at different doses or over longer periods remain unclear. Participants with resistant hypertension were a small subgroup, limiting conclusions for that population.
How to read the evidence
This is an individual patient data meta-analysis of three large randomized controlled trials — one of the strongest forms of evidence. The large sample size and use of raw patient data rather than aggregate summaries increases reliability.
When this study was published
Published in 2024 in the European Heart Journal, this is a recent and highly relevant analysis reflecting current clinical practice with semaglutide.
The bigger picture
GLP-1 receptor agonists like semaglutide are increasingly recognized for benefits beyond blood sugar and weight control. This study adds to growing evidence that these medications can meaningfully reduce cardiovascular risk factors, positioning them as potential multi-purpose treatments for patients with obesity and hypertension.
Questions still open
- Would semaglutide produce even larger blood pressure reductions if anti-hypertensive medications were kept constant rather than reduced?
- How does the blood pressure effect of semaglutide compare to dedicated anti-hypertensive drugs in head-to-head trials?
- Do the blood pressure benefits persist long-term, or do they depend on continued weight loss?
Common questions
Does semaglutide lower blood pressure more in people with high blood pressure?
Is the blood pressure reduction from semaglutide just because of weight loss?
Read the original research
Semaglutide and blood pressure: an individual patient data meta-analysis.
European heart journal, 45(38), 4124-4134
Citation
Kennedy, Cormac; Hayes, Peter; Cicero, Arrigo F G; Dobner, Stephan; Le Roux, Carel W; McEvoy, John W; Zgaga, Lina; Hennessy, Martina. (2024). Semaglutide and blood pressure: an individual patient data meta-analysis.. European heart journal, 45(38), 4124-4134. https://doi.org/10.1093/eurheartj/ehae564