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

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.

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.

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.

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.