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Study breakdown

CagriSema Drops Blood Pressure by 11 mmHg in Overweight Adults — Even in Resistant Hypertension

evidence
The takeaway

CagriSema reduced systolic blood pressure by 10.9 mmHg (vs. 2.8 for placebo) over 68 weeks, with 63% of participants reaching blood pressure targets and 40% reducing or stopping BP medications.

-10.9 mmHg systolic BP

CagriSema reduced blood pressure nearly 4 times more than placebo over 68 weeks, with 63% of participants reaching BP targets

What the researchers found

In the phase 3a REDEFINE 1 trial (n=3,417; 68 weeks), CagriSema 2.4 mg/2.4 mg vs. placebo showed:

- Systolic BP change: -10.9 vs. -2.8 mmHg

- Diastolic BP change: -5.4 vs. -1.7 mmHg

- BP target achievement at week 68: 63.0% vs. 32.0%

- Among resistant hypertension patients (n=167): 42.0% vs. 29.3% reached BP targets (OR 1.7; 95% CI 0.7-4.4)

- 39.6% of CagriSema patients on antihypertensive medications decreased or stopped treatment vs. 18.8% with placebo

The blood pressure reductions were clinically relevant across a wide range of subgroups including those stratified by baseline BMI, hypertension status, and resistant hypertension.

Why it matters

Obesity and hypertension frequently co-exist and compound cardiovascular risk. A treatment that addresses both simultaneously — reducing weight and blood pressure — could significantly reduce the need for multiple medications. The finding that 40% of patients could reduce or stop their blood pressure drugs is particularly meaningful for simplifying treatment and improving adherence.

How the study worked

Secondary and post hoc analyses of the REDEFINE 1 trial (NCT05567796), a phase 3a, 68-week, randomized, double-blind trial. Adults without diabetes with BMI ≥30 (or ≥27 with obesity-related complication) were randomized to CagriSema 2.4/2.4 mg (n=2,108), semaglutide 2.4 mg (n=302), cagrilintide 2.4 mg (n=302), or placebo (n=705), plus lifestyle intervention. Blood pressure changes were analyzed by subgroup including baseline hypertension status and medication use.

What this study cannot tell us

Blood pressure analysis was secondary/post hoc, not a pre-specified primary endpoint. The resistant hypertension subgroup was small (n=167) with wide confidence intervals. The trial excluded people with diabetes, limiting generalizability to the T2D population. Whether blood pressure benefits are directly from the drug or mediated entirely through weight loss was not fully resolved.

How to read the evidence

This is a secondary analysis of a large (n=3,417) phase 3a randomized, double-blind, placebo-controlled trial. While the blood pressure outcomes were not the primary endpoint, the trial design and sample size provide robust evidence.

When this study was published

Published in 2026 from the REDEFINE 1 trial, this represents the latest clinical evidence for CagriSema, which is being evaluated for regulatory approval.

The bigger picture

CagriSema represents the next generation of peptide-based obesity treatments, combining two complementary mechanisms (GLP-1 + amylin). These blood pressure findings add to its value proposition beyond weight loss alone, positioning it as a comprehensive cardiometabolic therapy that could reduce the overall medication burden for patients with obesity and hypertension.

Questions still open

  • How much of the blood pressure reduction is directly from CagriSema vs. secondary to weight loss?
  • Would CagriSema be effective as a primary hypertension treatment independent of weight management?
  • Do the blood pressure benefits persist long-term or only during active treatment?

Common questions

Can CagriSema replace blood pressure medication?
In this trial, about 40% of CagriSema-treated patients who were on blood pressure medications were able to reduce or stop them over 68 weeks. However, this should only be done under medical supervision. CagriSema is not approved as a blood pressure treatment — the BP reduction appears to be an important additional benefit alongside weight loss.
What is CagriSema and how does it work?
CagriSema combines two peptide drugs in one injection: semaglutide (a GLP-1 agonist that reduces appetite and improves blood sugar) and cagrilintide (an amylin analog that enhances satiety). Together, they produce greater weight loss than either drug alone, and this study shows they also significantly lower blood pressure.

Read the original research

CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1.

Hypertension (Dallas, Tex. : 1979), 83(2), e26055

Citation

Verma, Subodh; Böttcher, Morten; Brown, Paul; Dicker, Dror; Rubino, Domenica; Sbraccia, Paolo; Sharma, Arya M; Smedegaard, Lærke; Sørrig, Rasmus; Garvey, W Timothy. (2026). CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1.. Hypertension (Dallas, Tex. : 1979), 83(2), e26055. https://doi.org/10.1161/HYPERTENSIONAHA.125.26055