New weight loss medication may help lower blood pressure in adults with obesity

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The caller weight nonaccomplishment medicine tirzepatide importantly lowered nan systolic humor unit (the apical number successful a humor unit reading) for astir 500 adults pinch obesity who took nan medicine for astir 8 months, according to caller investigation published coming successful Hypertension, an American Heart Association journal.

Systolic humor pressure, aliases nan apical number successful nan humor unit reading, is simply a stronger predictor for cardiovascular decease than diastolic, aliases bottommost number, humor pressure. According to nan American Heart Association's 2024 Heart Disease and Stroke Statistics, much than 122 cardinal adults successful nan United States, aliases 47% of adults person hypertension, and astir 42% of adults person obesity.

Tirzepatide useful by mimicking 2 metabolic hormones successful nan body: it acts arsenic a glucagon-like peptide-1 (GLP-1) receptor agonist and besides arsenic a glucose limited insulinotropic polypeptide (GIP) receptor agonist. These hormones stimulate insulin secretion and sensitivity aft a personification eats. Together, they person been recovered truthful acold to thief modulate nan body's humor sweetener levels, slow down digestion and trim appetite, which makes a personification consciousness much afloat and eat less, starring to weight loss. In contrast, semaglutide has only nan GLP-1 hormone; it does not incorporate a GIP receptor agonist.

In 2022, nan Food and Drug Administration approved tirzepatide for medicine arsenic a curen for Type 2 diabetes. In precocious 2023, nan FDA besides approved it for chronic weight guidance for group pinch obesity (body wide scale of 30 kg/m2 aliases higher) aliases overweight (body wide scale of 27-29 kg/m2) and astatine slightest 1 weight-related wellness condition, specified arsenic precocious humor pressure, Type 2 glucosuria aliases precocious cholesterol.

"Our findings bespeak treating obesity pinch nan weight nonaccomplishment medicine tirzepatide whitethorn beryllium an effective strategy for preventing aliases treating precocious humor pressure," said lead study writer James A. de Lemos, M.D., FAHA, nan Kern Wildenthal, M.D., Ph.D., distinguished chair of cardiology and a professor of medicine astatine UT Southwestern Medical Center successful Dallas. "Although tirzepatide has been studied arsenic a weight nonaccomplishment medication, nan humor unit simplification successful our patients successful this study was impressive. While it is not known if nan effect connected humor unit was owed to nan medicine aliases nan participants' weight loss, nan little humor unit measures seen pinch tirzepatide rivaled what is seen for galore hypertension medications."

The existent investigation was a planned sub-study including 600 of nan participants from nan SURMOUNT-1 weight nonaccomplishment study to find if location was an effect connected humor pressure. The sub-study was designed to measure nan effects of tirzepatide connected humor unit levels arsenic measured by 24-hour ambulatory humor unit monitoring successful group pinch obesity but without Type 2 diabetes.

Participants received either a placebo aliases a dose of tirzepatide successful 1 of 3 strengths (5 mg, 10 mg aliases 15 mg). About one-third of participants reported they had precocious humor unit astatine nan opening of nan study and were taking 1 aliases much hypertension medications. When nan sub-study began, each of nan participants had humor unit levels that were little than 140/90 mm Hg, and if they utilized humor unit medications, they were required to person been taking their humor unit medications for astatine slightest 3 months. The sub-study included participants who had hypertension and who had normal humor pressure.

The study was conducted from December 2019 to April 2022, and nan subordinate results aft 36 weeks of taking tirzepatide indicate:

  • For participants taking 5 mg of tirzepatide, location was an mean simplification successful systolic humor unit of 7.4 mm Hg.
  • For participants taking 10 mg of tirzepatide, location was an mean simplification successful systolic humor unit of 10.6 mmHg.
  • For participants taking 15 mg of tirzepatide, location was an mean simplification successful systolic humor unit of 8.0 mm Hg.
  • The blood-pressure lowering effects of tirzepatide were evident successful humor unit measures taken during some nan time and night. Nighttime systolic humor unit is simply a stronger predictor for cardiovascular decease and all-cause decease than daytime humor unit readings.

The reductions successful systolic humor unit were accordant crossed subgroups of participants successful nan study who were categorized by further factors, including age, sex, assemblage wide scale and hypertension-related consequence factors.

Study inheritance and details:

  • SURMOUNT-1 was a randomized study connected nan effect of expanding doses of tirzepatide connected weight loss. It recovered that successful participants pinch overweight aliases obesity (body wide scale (BMI) ≥27 kg/m2), once-weekly injections of 5 mg, 10 mg aliases 15 mg of tirzepatide led to mean weight reductions of 15%, 19.5% and 20.9%, respectively, compared to placebo.
  • The sub-study included 600 adults from SURMOUNT-1: 155 participants received placebo; 145 were taking tirzepatide 5 mg; 152 were taking tirzepatide 10 mg; and 148 were taking tirzepatide 15 mg.
  • Blood unit measurements were disposable and analyzed for 494 participants who valid ambulatory humor unit monitoring information astatine nan opening of nan study and astatine week 36.
  • Only nan study participants pinch astatine slightest 70% valid readings connected ambulatory monitoring and a minimum of 20 daytime and 7 nighttime readings were included successful nan information analyses. This was 494 retired of 600 first participants.
  • 69% of study participants self-identified arsenic female, and 31% self-identified arsenic male. 66.8% self-identified arsenic achromatic adults, 11.8% self-identified arsenic Black adults and 25% self-identified arsenic Hispanic ethnicity.
  • The mean property of nan participants was 45.5 years, and their mean BMI was 37.4 kg/m2, which meets nan criteria for obesity (obesity is BMI≥30). People pinch obesity person an accrued consequence of precocious humor pressure, bosom disease, changeable and Type 2 diabetes, arsenic good arsenic different wellness conditions.
  • Ambulatory humor unit monitoring utilized successful this study included humor unit measurements each 30 minutes during nan time and each hr astatine night, providing a much broad appraisal of humor unit than successful agency aliases regular location humor unit measurements. For ambulatory humor unit monitoring, study participants wore a humor unit monitoring instrumentality for a 24- to 27-hour play that measured humor unit passim waking and sleeping hours. Ambulatory humor unit monitoring was conducted erstwhile participants first began taking tirzepatide astatine nan commencement of nan study and aft 36 weeks of being enrolled successful nan study.

The 2017 ACC/AHA Guideline for nan Prevention, Detection, Evaluation, and Management of High Blood Pressure successful Adults classifies hypertension, aliases precocious humor pressure, arsenic having apical and bottommost humor unit measures greater than aliases adjacent to 130/80 mm Hg.

Study limitations see that it was only conducted successful a subset of nan original 2,539 SURMOUNT-1 participants; nan ambulatory humor unit monitoring was only measured astatine 2 points successful nan study -- baseline and astatine 36 weeks; and measurements were only taken erstwhile per hr astatine nighttime to minimize nan load connected study participants. In addition, changes successful nutrient intake and 24-hour urine sodium excretion were not assessed, meaning nan publication of dietary modifications including brackish intake aliases different changes that whitethorn thief to trim humor unit are chartless and cannot beryllium estimated.

"Overall, these information are encouraging that caller weight-loss medications are effective astatine reducing assemblage weight and they are besides effective astatine improving galore of nan cardiometabolic complications of obesity including hypertension, Type 2 glucosuria and dyslipidemia, among others. While nan effect of each of these beneficial effects is individually important, galore of these obesity-related complications enactment synergistically to summation nan consequence of cardiovascular disease. Thus, strategies that mitigate aggregate obesity-related complications whitethorn trim nan consequence of cardiovascular events," said Michael E. Hall, M.D., M.S., FAHA, chair of nan penning group for nan Association's 2021 technological connection connected weight-loss strategies for prevention and curen of hypertension and chair of nan section of medicine astatine nan University of Mississippi Medical Center successful Jackson, Mississippi.

"Additional studies will beryllium basal to find nan semipermanent effect connected cardiovascular events specified arsenic bosom onslaught and bosom failure. Also, studies are needed to analyse what happens to humor unit erstwhile medications for illustration tirzepatide are discontinued -- does nan humor unit rebound and spell backmost up, aliases does it stay lowered?" Hall concluded.

The study was funded by Eli Lilly and Company, nan shaper of tirzepatide.