Zepbound

Weight Loss Drugs Significantly Lower Blood Pressure, Study Finds

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Certain groups saw a significant decrease in numbers.

preview for 5 Ways to Keep Your Heart Healthy
  • Weight loss drug tirzepatide is linked with a drop in blood pressure in a new study.
  • Researchers found a substantial reduction within 36 weeks on the medication.
  • Doctors say this could be linked to weight loss or something else entirely.

Medications like semaglutide and tirzepatide have made headlines for months for their role in helping people with obesity lose a significant amount of weight. But research is consistently finding additional benefits of going on these medications. Now, there’s a new one to add to the list: They may help lower blood pressure.

That’s the major finding from a new study published in the American Heart Association’s journal, Hypertension. For the study, researchers analyzed data from 600 people who participated in the SURMOUNT-1 weight loss study to see if there was an impact on blood pressure in people who took tirzepatide, which was approved by the U.S. Food and Drug Administration (FDA) for weight loss in November under the name, Zepbound.

Study participants either received a placebo or a tirzepatide dose of 5 milligrams, 10 milligrams, or 15 milligrams. About 1/3 of study participants had high blood pressure (a.k.a. hypertension) at the start of the study and were taking one or more medications for it.

After 36 weeks, researchers found that study participants in all of the tirzepatide groups had lowered blood pressure by the end, with the biggest reduction in systolic blood pressure (the top number in a reading) being 10.6 mmHg in the 10 milligram group.

The researchers also found that people on tirzepatide had lowered blood pressure when they did measurements during the day and at night. Here’s what doctors want you to know about the findings. (Note: Prevention no longer uses the Body Mass Index (BMI) as a measurement of health.)

Why might weight loss drugs help lower blood pressure?

Doctors agree that a lot of this is likely due to weight loss. “Typically, the greater the degree of weight loss, the greater the degree of blood pressure decrease,” says Colleen Tewksbury, Ph.D., M.P.H., R.D., a registered dietitian and associate professor at Penn Medicine. “It may not be the medication by itself.”

In this particular study, patients who took tirzepatide lost up to 20.9% of their body weight compared to those who took a placebo.

“The findings are impressive, although not unexpected given the critical role that weight gain plays in causing hypertension in the first place,” says Christoph Buettner, M.D., Ph.D., chief of the division of endocrinology at Rutgers Robert Wood Johnson Medical School. Since high blood pressure is often linked to having obesity or overweight, lowering a person’s body fat should reduce their blood pressure, he says.

In fact, weight loss can be so effective for lowering blood pressure, that patients on blood pressure medicines should check in with their doctor regularly if they’re losing weight, says Mir Ali, M.D., a bariatric surgeon and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA. “Their blood pressure medications will likely need to be adjusted,” he says.

But it’s also possible that tirzepatide itself impacts blood pressure, says Sahil Parikh, M.D., director of endovascular services at NewYork-Presbyterian/Columbia University Irving Medical Center. “It remains unclear if the blood pressure reduction is benefitting from the drug having a direct effect on blood pressure, as opposed to the indirect impact on blood pressure through weight loss alone,” he says.

The study focused on tirzepatide, but Dr. Buettner says that fellow weight loss drug semaglutide “has similar effects” when it comes to impact on blood pressure.

While high blood pressure is linked to serious health conditions like heart attack, stroke, and heart failure, “we will need long-term trial results” to see if weight-loss medications can reduce those risks, too, says Laxmi Mehta, M.D., a non-invasive cardiologist at The Ohio State University Wexner Medical Center.

How tirzepatide works

Tirzepatide is a medication that’s used to help manage type 2 diabetes (under the name Mounjaro) and for weight loss (under the name Zepbound). It’s an injectable medication that’s taken once a week to help with weight loss in people who have obesity or overweight.

The medication specifically targets glucagon-like peptide 1 (GLP-1) agonists, which encourage the body to produce more insulin (a hormone that escorts blood sugar to cells, where they’re used for energy) when blood sugars start to rise, along with something called glucose-dependent insulinotropic polypeptide (GIP) receptors, Dr. Ali explains.

Zepbound can also make you feel fuller longer, as well as reduce cravings, causing people to feel less hungry than usual on the medication.

Natural ways to lower blood pressure

If you’re concerned about your blood pressure, doctors say there are a few things you can do:

  • Be active. “Exercise is critical to heart health, and it is one of the best ways that you can lower your blood pressure naturally,” says Nicole Weinberg, M.D., a cardiologist at Providence Saint John’s Health Center in Santa Monica, CA.
  • Ask your doctor if you should try to lose weight. “For every 10 pounds of weight loss, you can expect a significant blood pressure drop,” Dr. Weinberg says.
  • Rethink your diet. Dr. Buettner recommends following a heart-healthy diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy.
  • Limit alcohol. “If you drink alcohol, do so in moderation,” Dr. Buettner says.
  • Try to manage your stress levels. That can include doing things like deep breathing, meditation, yoga, or things that relax you, Dr. Buettner says.

It’s also important to stay on top of your blood pressure, even if you do everything else right, Dr. Parikh says. “As we age, there is a tendency for blood pressure to go up, and in time, medication may be critical,” he says.

As of right now, there’s nothing to suggest that weight loss drugs will lower your blood pressure if you don’t have overweight or obesity, Tewksbury says. But if you’re concerned about your blood pressure levels, check in with your doctor. They should be able to offer personalized advice.

“Zepbound,” the newest weightloss drug

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As Zepbound dominates headlines as a new obesity-fighting drug, experts warn that weight loss shouldn’t be the only goal.

A tube with the word Zepbond on it, designed specifically for weight loss.

Zepbound is the newest addition to the weight loss drug arena. In November 2023, it joined the list of obesity-fighting drugs – administered as an injection – to be approved by the U.S. Food and Drug Administration. 

The key to Zepbound’s weight loss potential is its active ingredient, tirzepatide. This is the same active ingredient found in the drug Mounjaro, which is approved to treat Type 2 diabetes. 

The relationship between Zepbound and Mounjaro is similar to two other popular drugs making headlines, Wegovy and Ozempic. Both Wegovy and Ozempic contain the active ingredient semaglutide, with Ozempic approved for the treatment of Type 2 diabetes and Wegovy approved for the treatment of obesity.

Tirzepatide and semaglutide both mimic the digestive hormone GLP-1, which is released by the intestines when we eat to stimulate insulin production and help regulate blood sugar. GLP-1 also suppresses appetite while promoting a sensation of fullness.

Weight loss medications are intended to be used in conjunction with lifestyle changes, such as exercise and a healthy diet. But too often, people view them as a silver bullet for weight loss. And the high price tag and variable insurance coverage for these popular weight loss drugs create a barrier for many people. 

Health risks of obesity

The potential impact of these drugs is staggering, since more than 2 in 5 American adults are obese, according to the National Institutes of Health. 

Obesity is not just an American issue, nor is it going away. The World Obesity Federation estimates that by 2030, 1 in 5 women and 1 in 7 men will be living with obesity worldwide.

Many serious health conditions are associated with obesity, including heart disease, diabetes, high blood pressure, stroke, certain cancers, and osteoarthritis. By treating obesity, a person can reduce or reverse obesity-related disease and improve both their health and quality of life.

However, long-term weight management depends on a number of complex factors. Meal timing and types of foods eaten can affect energy levels, satisfaction and hunger levels. A person’s typical schedule, culture and preferences, activity level and health history must be taken into consideration as well. No single “best strategy” for weight management has been identified, and research indicates that strategies for weight loss and maintenance need to be individualized.

In addition, it is critical to note that research on the long-term effects of these newer weight loss drugs is limited. The available research has focused specifically on weight loss, heart health and metabolism and has found that ongoing use of these new medications is necessary to maintain improvements in weight and related health benefits. 

Common side effects and the emotional toll experienced by those who regain weight once they stop taking the drugs are trade-offs that need to be considered. More research is needed to better understand the long-term impact of both direct and indirect health consequences of taking drugs for weight loss.

It’s not just what you see on the scale

Throughout my years working as a registered dietitian, I have counseled numerous people about their weight loss goals. I often see a hyperfocus on weight loss, with much less attention being placed on the right nutrients to eat.

Societal standards and weight stigma in the health care setting can negatively affect patients’ health and can lead them to obsess about the number on a scale rather than on the health outcome.

Weight loss may be necessary to reduce risks and promote health. But weight loss alone should not be the end goal: Rather, the focus should be on overall health. Tactics to reduce intake and suppress appetite require intention to ensure that the body receives the nutrients it needs to support health.

Additionally, I remind people that long-term results require attention to diet and lifestyle. When a person stops taking a medication, the condition it’s meant to treat can often return. If you stop taking your high blood pressure pills without altering your diet and lifestyle, your blood pressure goes back up. The same effects can happen with medications used to treat cholesterol and obesity.

Nourish your body with nutrients

Despite the prevalence of obesity and the emergence of newer drugs to treat it, 95% of the world’s population doesn’t get enough of at least one nutrient. According to one study, nearly one-third of Americans have been found to be at risk of at least one nutrient deficiency. Additional research indicates that those actively trying to lose weight are more prone to nutrient deficiencies and inadequate intake. 

For instance, a decline in iron intake can lead to iron deficiency anemia, which can cause fatigue as well as an increased risk of many conditions. Adequate intake of calcium and Vitamin D reduce the risk of bone fractures, yet many people get less than the recommended amounts of these nutrients. 

It is true that a healthy body weight is associated with reduced health risks and conditions. But if a person loses weight in a manner that does not provide their body with adequate nourishment, then they may develop new health concerns. For example, when a person follows a diet that severely restricts carbohydrates, such as the ketogenic diet, intake of many vitamins, minerals, phytochemicals – or biologically active compounds found in plants – and fiber are reduced. This can increase risk of nutrient deficiencies and impair the health of bacteria in our gut that are important for nutrient absorption and immune function.

Nutrition recommendations set by the Food and Nutrition Board of the National Academies of Sciences, Engineering, and Medicine and the Dietary Guidelines for Americans provide guidance and resources to help meet nutrient needs to promote health and prevent disease, regardless of the strategy used to lose weight.

Optimizing health

There is no doubt that striving for a healthy body weight can reduce certain health risks and prevent chronic disease. Whether a person strives to maintain a healthy body weight through diet alone or with medications to treat obesity, the following tips can help optimize health while attempting to lose weight.

  1. Adopt an individualized approach to healthy behaviors that promote weight loss while considering personal preferences, environmental challenges, health conditions and nutrient needs.
  2. Focus on nutrient-dense foods to ensure the body is getting required nutrients for disease prevention and optimal function. If medications reduce your appetite, it is crucial to maximize the amount of nutrients in the foods you do consume.
  3. Include exercise in your program. Weight loss as a result of reduced calorie intake can decrease both fat and lean body mass, or muscle. An exercise routine that includes strength training will help improve muscle strength and preserve muscle during weight loss. 
  4. Seek professional help. If you are uncertain about how to adopt an individualized approach while ensuring adequate intake of essential nutrients, talk to a registered dietitian. They can learn about your individual needs based on preferences, health conditions and goals to make dietary recommendations that support health.