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Two new studies show that blood pressure drops significantly in adults who undergo certain weight loss treatments. One study showed that people who received weekly injections of the drug tirzepatide had significantly lower blood pressure. Another found that participants who underwent bariatric surgery had significantly improved blood pressure control after five years compared to participants who only took antihypertensive drugs.
The two studies looked at different interventions and outcomes, but taken together they suggest that effective treatment of obesity may be key to improving overall heart health, said Dr. Harlan Krumholtz, a cardiologist at Yale University. He said that it provides strong evidence to support the concept that there is a gender. Although the relationship between obesity and diseases such as high blood pressure, diabetes and other heart diseases is well established, until now there have been no effective treatments for obesity, he said.
“It's a new era,” Krumholz said. “This is not a new insight, but we now have tools such as anti-obesity drugs and surgery that can have a big impact.”
The first study, published Monday in the American Heart Association journal Hypertension, found that overweight patients who took the drug tirzepatide, sold under the brand names Zepbound for obesity and Munjaro for diabetes, for nine months Or found that obese adults had significantly lower blood pressure. .
This new research large scale clinical trial Previous research has shown that weekly tirzepatide injections can reduce body weight by up to 22% in overweight or obese adults, helping prompt the U.S. Food and Drug Administration to: Approving drugs for chronic weight management in November. The study was funded by the drug's manufacturer, Eli Lilly.
To evaluate the effects of tirzepatide on blood pressure, researchers studied adults with a body mass index of 27 or higher, no type 2 diabetes, and either normotension or hypertension who participated in the initial clinical trial. 600 people were registered. It was under control. The participant had her blood pressure monitored for 1 day before starting treatment and again after weekly tirzepatide injections for 9 months.
The results showed that the participants' systolic blood pressure, the highest blood pressure measurement that is a strong predictor of heart disease, decreased significantly.
Participants who took 5 milligrams of tirzepatide weekly experienced an average decrease in systolic blood pressure of 7.4 mmHg, participants who took 10 milligrams experienced an average decrease of 10.6 mmHg, and participants who took 15 milligrams experienced an average decrease of 8.0 mmHg.
“An 8-point difference is an impressive effect that matches or exceeds many of the common blood pressure medications,” said Dr. Harlan Krumholz, a cardiologist at Yale University who was not involved in the study..
Dr. Michael E. Hall, chairman of the University of Mississippi School of Medicine, said the actual effect of tirzepatide on blood pressure may be even more significant, given that most of the study participants did not have pre-existing hypertension. The medical center was not involved in this study.
Tilzepatide works by mimicking the actions of two different intestinal hormones. When blood sugar levels rise after a meal, the drug stimulates the body to produce more insulin, lowering blood sugar levels. It also slows down the movement of food from the stomach, making you feel fuller for longer. It works similarly to semaglutide, the active compound in the weight loss drug Wegovy and its sister drug, the diabetes drug Ozempic. Wegovy has been shown to reduce the risk of heart attack, stroke, and heart-related death by 20% in people with heart disease and obesity or overweight. I studied last summer.
As for the new study, it's unclear whether the large drop in blood pressure was due to participants losing weight in the larger study or to the medication. The study also did not take into account the participants' dietary intake, which could have influenced the results.
Additional studies will be needed to determine the effects of tirzepatide on direct cardiovascular conditions such as heart attack and heart failure, and to assess whether changes in blood pressure are reversible after stopping the drug. , said Hall, who also chaired the American Heart Association's 2021 writing group. scientific statement Regarding weight loss and high blood pressure, news release.
“Overall, these data show that new weight loss drugs are effective at reducing body weight and are also effective at improving many of the cardiometabolic complications of obesity, including hypertension, type 2 diabetes, and dyslipidemia. “This suggests that it is true,” he said.
A second study published Monday in the Journal of the American College of Cardiology found that adults with high blood pressure and obesity who underwent bariatric surgery had a lower BMI five years later and those who were only using antihypertensive medications. It was found that the amount of blood pressure medication taken after 5 years was lower compared to the previous year. medicine.
In the first-of-its-kind study, 100 adults with obesity and hypertension were randomly assigned to a treatment regimen of bariatric surgery and antihypertensive drugs or antihypertensive drugs alone. After five years, those who had bariatric surgery had an average BMI of 28, while those who only received antihypertensive medication had an average BMI of 36.
More than 80% of people who had bariatric surgery were able to reduce the number of blood pressure medications they were taking, compared with 14% of those who were taking medication alone. And nearly 50% of people who undergo bariatric surgery achieve hypertension remission, defined as controlling blood pressure without medication.
“This has shown a huge impact on our ability to reduce blood pressure medications and help people get off their high blood pressure medications. That's very impressive,” said the Stanford University Professor of Preventive Cardiology. said the director, Dr. David Mallon, who was not involved in the study.
Given that the study was conducted at a single center and with a small number of participants, the results may not be generalizable to a broader population, but the results are interesting, Maron said. he said. He said bariatric surgery is known to be highly effective in treating obesity and diabetes, but many people are unaware of its benefits and are hesitant to undergo such invasive treatments. added.
In the future, Hall said, obese patients who want to control their blood pressure will likely be able to choose between bariatric surgery or a drug like tirzepatide, depending on the nature of their disease and their preferences.
Relationship between high blood pressure and obesity
According to , more than 47% of adults in the United States have high blood pressure (defined as blood pressure of 140/90 mmHg or higher) and nearly 42% of adults are obese. AHA's 2024 Heart Disease and Stroke Statistics. These diseases are closely related, as obesity is the main cause of high blood pressure. According to , about 75% of high blood pressure can be attributed to obesity. american heart association. And high blood pressure is a major risk factor for heart disease, including coronary artery disease and stroke.
Dr. Ania Jastrebov, director of the Yale Center for Obesity Research, who helped conduct the large-scale weight loss trial, said, “Treatment of one disease, obesity, can reduce hundreds of other obesity-related symptoms, including high blood pressure.'' “There is a gender,” he wrote in an email. .
Although there are effective blood pressure medications, only about a quarter of people with high blood pressure have their blood pressure properly controlled, Hall said. This is often due to people not taking their medication. Finding ways to simplify and combine treatments for these diseases would make life much easier for both patients and doctors, Hall added.
Krumholz says that while much of the hype around tirzepatide focuses on its weight loss effects, the real health benefits lie downstream, with weight loss leading to lower blood pressure and improved athletic performance, which can improve heart health. He said it would lead to improved health conditions. He believes the drug's weight-loss effect is an enjoyable side effect that makes people more likely to take the drug.
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Before the development of tirzepatide and similar obesity drugs, lifestyle modification was the main treatment. It's a way to treat obesity, Krumholz said. Although these are beneficial, a healthy diet and more exercise are often not enough to combat the disease of obesity and our bodies' evolutionary tendency to gain weight back. he added.
“Patients end up feeling bad about themselves and feeling frustrated and guilty,” he says. “these [drugs] It almost represents a miracle. [People] Now you can take drugs that can not only help you lose weight, but also improve your health. ”
But the cost and inadequate insurance coverage of these new weight loss drugs prevent many eligible people from taking advantage of them, Krumholz said. Unless these barriers are addressed, he warned, these new treatments could instead lead to worsening health disparities in the United States.
CNN's Meg Tyrrell contributed to this report.
