Experts say reducing blood pressure can help lower the risk of heart disease.
- Researchers say people who took tirzepatide saw a
significant reduction in their blood pressure over 36 weeks.
- Tirzepatide, which is prescribed for type 2
diabetes (Mounjaro) and obesity (Zepbound), is being studied for its
effects on cardiovascular conditions as well.
- The new findings further support the potential
role of the drug in treating a host of conditions, including high blood
pressure, obesity, and diabetes.
Researchers are
reporting that people who took tirzepatide, a type 2 diabetes and obesity medication, showed a
significant reduction in blood pressure levels after 36 weeks.
They reported their
findings in a study published today in the journal Hypertension.
Tirzepatide, which was
originally indicated for the treatment of diabetes and sold under the trade
name Mounjaro,
was approved for
the treatment of obesity under the name Zepbound in
November 2023.
Due to well-established
links between obesity and cardiovascular
conditions, researchers are taking a
closer look at how tirzepatide and similar drugs, such as semaglutide (Ozempic
and Wegovy), known as GLP-1 RAs can
impact heart health.
Tirzepatide is a
combination of GLP-1 RA and GIP, which
simulate hormones in the body that affect insulin production, blood glucose,
digestion, and feelings of satiety or fullness.
Results from
weight loss medication and hypertension study
In their research
letter, the scientists said that blood pressure improved in people who took
tirzepatide over 36 weeks, compared to study participants who took a placebo.
However, the researchers
said they did not establish a dose-dependent improvement, meaning that
individuals who took more of the drug did not see better results than those who
took less of it.
Additionally, it is also
unclear from the research whether blood pressure decreased solely due to weight
loss or if there was an additional mechanism at work due to the medication.
Experts do say that the
findings hint at further benefits of the drug beyond diabetes and obesity.
“These are statistically
significant and clinically meaningful reductions in blood pressure,” said Dr. Matthew Alexander, an assistant professor of medicine at Vanderbilt
University Medical Center in Tennessee who wasn’t affiliated with the research.
“Reductions in
ambulatory blood pressure in this sub-study provide key evidence for blood
pressure lowering with tirzepatide,” he told Medical News Today.
“This included reductions in not only 24-hour and daytime blood pressure but
also nighttime blood pressure, which has additional important prognostic
significance.”
Significant lowering of
blood pressure
The blood pressure
research was a sub-study of the SURMOUNT-1 trial, a randomized, placebo-controlled trial investigating tirzepatide’s
effects on weight loss. The trial was funded by Eli Lilly and Company, the
manufacturer of Mounjaro and Zepbound.
In the sub-study, which
was conducted from December 2019 to April 2022, scientists enrolled 600
participants who were given different doses of tirzepatide (5mg, 10mg, and
15mg) or a placebo.
The groups were split
almost evenly with about 150 participants in each. The average age of
individuals in the study was 45 years old. Most were women (68%) and either
white (66%) or Hispanic (25%).
At the end of the study
nearly 500 participants in the study had valid blood pressure data to report.
On average, individuals
who took tirzepatide lowered their 24-hour systolic blood pressure (the
top number in a blood pressure reading) compared with placebo. Specific dosage
of the drug affected blood pressure as follows: The 5mg tirzepatide group saw a
7 point decrease compared to baseline while there was a 10 point drop for the
10mg group and 8 points for 15mg.
Tirzepatide also lowered
24-hour diastolic blood pressure (the bottom number) compared to a placebo. The
5mg group experienced a 2 point decrease while there was a nearly 3 point drop
for the 10mg group and less than a 1 point change for the 15mg group.
The effects of the drug on blood pressure were apparent during both daytime and nighttime blood pressure readings, researchers said.
Experts react to trizpetide study
Dr. Sun Kim, an associate professor of medicine in the
endocrinology division at Stanford Medicine in California who wasn’t affiliated
with the research, told Medical
News Today that it would have
been nice to see a linear association between blood pressure and dosage.
“Because we know that
part of the mechanism for blood pressure lowering is due to weight loss, we
would expect greater decrease in blood pressure with more weight loss and
higher dose of tirzepatide… In the current study, blood pressure lowering was
greatest with tirzepatide 10mg,” she said.
The study also
identified an expected increase in 24-hour heart rate of between 2 and 6 beats
per minute respectively for each dose after 36 weeks. Prior studies have
also noted this association.
Questions persist regarding
whether the observed effects on blood pressure are attributed solely to weight
loss or if the drug itself plays a direct role.
“It’s certainly at least
mostly a blood pressure effect. It could be that there’s some direct effect of
the drug,” said Dr. James de Lemos, a study author and a professor in the Department of
Internal Medicine and Chief of the Division of Cardiology at UT Southwestern
Medical Center in Texas.
The ‘gold
standard’ on blood pressure metrics
The study utilized 24-hour ambulatory blood pressure readings, which de Lemos called “the gold standard” for
assessing blood pressure.
Unlike the more common
in-office blood pressure measurement, which only gives a single reading at a
single point in time, 24-hour ambulatory blood pressure readings take readings
throughout the day and night.
“These are blood
pressure machines that you take home with you that measure blood pressure very
frequently and give a more comprehensive assessment of blood pressure than
office-based measurements,” de Lemos told Medical News Today.
According to the latest guidelines from the American Heart Association,
hypertension (high blood pressure) is classified as any reading of 130/80 or
higher. A healthy blood pressure range should be below 120/80.
For individuals with
obesity and diabetes, the findings could show promise in tackling a host of
serious co-morbidities such as metabolic syndrome.
“We’re entering an era
for the first time where pharmacologic treatment of obesity and diabetes may
yield tangible benefits in terms of long-term cardiac outcomes,” said de Lemos.
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