The GLP-1/GIP receptor agonist diabetes medication tirzepatide has an antihypertensive benefit in addition to its weight loss effects in people with obesity, a new study shows.
The findings come from a trial (link here) involving almost 500 patients with obesity (average BMI 37.4 kg/m2) but no diabetes who were treated with tirzepatide for eight months and who underwent 24-hour ambulatory BP monitoring at the start and end of the study.
Participants received weekly injection doses of tirzepatide (5 mg, 10 mg or 15 mg) or placebo for 36 weeks. About one-third of participants had treated hypertension at baseline, and all had a BP less than 140/90 mm Hg.
As expected, at the 36-week follow-up, there was significant weight loss in the tirzepatide group: 15%, 19.5%, and 20.9% for the 5 mg, 10 mg, or 15 mg dose groups, respectively, compared to placebo.
At baseline, the mean (SD) 24-hour systolic BP was 124.6 (10.4) mmHg for the patient cohort. After 36 weeks of treatment with tirzepatide, there were significant dose-related reductions in 24-hour systolic BP in all treatment groups compared with placebo. The placebo-adjusted systolic BP change from baseline was −7.4 (95% CI, −10.0 to −4.7) mmHg for 5mg tirzepatide, −10.6 (95% CI, −13.2 to −8.0) mmHg for 10-mg and −8.0 (95% CI, −10.6 to −5.4) mmHg for 15-mg tirzepatide.
The results were consistent for both day and night-time BP, with significant reductions versus placebo for each tirzepatide dose. There were no associations between systolic BP reduction and factors such as age, sex, BMI, systolic BP, presence of hypertension, antihypertensive medication use or glycaemic status. However, there was a suggestion that changes in 24-hour systolic BP were partially mediated by weight change, with a significant correlation between changes in SBP and changes in body weight (r=0.31; P<0.0001).
For diastolic BP there were significant reductions from the baseline level of 72.1 (7.7) mmHg in the 5 mg (−2.0 mmHg) and 10 mg (−2.9 mmHg) but not 15 mg (−0.5 mmHg) tirzepatide dose groups.
At 36 weeks, heart rate increased with tirzepatide versus placebo by 2.1, 2.3, and 5.4 beats per minute, respectively, with tirzepatide 5, 10, and 15 mg.
The study investigators said the findings of a reduction in nighttime systolic BP was particularly significant as this was a stronger predictor for cardiovascular death and all-cause death than daytime and 24-hour systolic BP.
And while there was some suggestion that tirzepatide-induced body weight reduction effects were associated with BP reductions, the drug may also have effects on BP independent of weight loss, they said.