Does Semaglutide Lower Blood Pressure

Semaglutide is a drug that is mostly used to treat type 2 diabetes. Newer studies, however, indicate that it might also help some people drop their blood pressure.

The research supporting semaglutide’s effects on blood pressure and its implications for individuals with hypertension will be examined in this article.

What is Semaglutide?

Semaglutide, also known by the brand names Ozempic and Wegovy, is a member of the group of drugs known as glucagon-like peptide-1 (GLP-1) receptor agonists. It resembles GLP-1, a hormone that aids in blood sugar regulation. The FDA initially authorized semaglutide in 2017 for the treatment of type 2 diabetes.

Since then, research has demonstrated that semaglutide helps diabetics lose weight and reduce their risk of cardiovascular disease. According to recent research, it may also lower blood pressure. However, how solid is the evidence? And might semaglutide be used to treat high blood pressure?

Can Semaglutide Help With High Blood Pressure?

A 2023 meta-analysis of 29 trials with nearly 26,000 individuals found that semaglutide decreased systolic blood pressure (the top number) by an average of 2.3 mmHg when compared to a placebo, supporting early data suggesting that semaglutide may lower blood pressure through numerous pathways.

Additionally, it reduced the bottom number, or diastolic pressure, by an average of 0.09 mmHg. In both individuals with and without diabetes, these outcomes were consistent. According to the analysis, oral formulations or subcutaneous semaglutide are useful for lowering SBP.

Data from six semaglutide randomized controlled trials were examined in a different 2023 review. Semaglutide therapy was observed to reduce systolic blood pressure by 4.83 mmHg to 5.65 mmHg.

Even though these benefits might appear minor, a mere 5 mmHg drop in systolic blood pressure can cut the risk of death, heart disease, and stroke.

How Does Semaglutide Potentially Lower Blood Pressure?

Researchers believe semaglutide may lower blood pressure through several mechanisms:

Weight loss

Semaglutide lowers hunger and aids in weight loss by acting as an agonist of the GLP-1 receptor. Significant drops in blood pressure are linked to losing excess body weight. Nevertheless, studies show that semaglutide reduces blood pressure without relying on weight loss alone.

Diuretic effects

Semaglutide reduces blood volume and fluid retention by slightly increasing urine production. This lowers blood pressure by reducing the amount of blood the heart must pump.

Improved insulin sensitivity

Semaglutide helps reduce insulin resistance and hyperinsulinemia by improving the body’s reaction to insulin. This enhances blood flow and encourages vasodilation, or the widening of blood vessels.

Arterial stiffness

Research indicates that semaglutide therapy is linked to a reduction in arterial stiffness. Peripheral resistance can be reduced by more flexible blood vessel walls, which can expand more easily in response to blood flow.

Direct vascular effects

Semaglutide, an agonist of the glucagon-like peptide-1 (GLP-1) receptor, may directly affect the endothelium, or blood vessel lining, to cause vasorelaxation. Additionally, it might positively change hormones that control vascular tone, such as endothelin-1.

Sympathetic nervous system activity

According to certain studies, GLP-1 receptor agonists can lessen the renin-angiotensin-aldosterone system activation and suppress sympathetic drive. This lessens the strain on the heart and arteries.

Anti-inflammatory effects

Semaglutide may enhance endothelial function and promote healthy vasodilation by blocking inflammatory mediators. Hypertension is associated with chronic inflammation.

Key Factors Influencing Blood Pressure Reduction with Semaglutide

Although the amount of blood pressure decrease varies from person to person, semaglutide can lower blood pressure. The degree to which semaglutide medication lowers blood pressure depends on a number of important factors and situations. These elements consist of:

• Baseline Blood Pressure Levels: Patients who have higher baseline systolic blood pressure at the beginning have larger drops than those whose levels are only slightly increased. Larger declines are frequently seen in those with hypertension or prehypertension.
• Type 2 Diabetes: Patients with diabetes benefit more from semaglutide than those without the disease, most likely as a result of better glycemic control.
• Weight Status: Since semaglutide frequently causes weight loss, those who are overweight or obese typically see larger decreases.
• Treatment Length: Throughout the course of months or years of continuing semaglutide medication, the blood pressure-lowering effects are sustained.
• Formulation: Systolic and diastolic blood pressure are decreased in a similar way by oral and injectable semaglutide.

Safety Profile and Side Effects

Semaglutide is generally safe and well-tolerated when used carefully under medical supervision. However, some people may experience temporary side effects like:

• Dizziness – Since semaglutide lowers blood pressure, some users report occasional dizziness, especially when standing up. Staying well-hydrated can help minimize symptoms.
• Headaches – Headaches are another possible side effect related to blood pressure changes. They tend to resolve on their own but notify your doctor if severe.
• Gastrointestinal effects – Like other GLP-1 drugs, semaglutide may cause temporary GI issues like nausea, vomiting, or diarrhea when first starting treatment. These typically improve over time.

Semaglutide may infrequently result in or worsen ocular problems from diabetic retinopathy. Therefore, it is advised to have ophthalmological surveillance while using semaglutide.

Who Might Benefit From Using Semaglutide?

The following people may benefit from semaglutide’s blood pressure-lowering effects the most:

• Uncontrolled hypertension: Adding semaglutide may help lower your blood pressure if it continues to rise in spite of lifestyle modifications and other antihypertensive drugs.
• Obesity-related hypertension: Semaglutide’s dual effects on blood pressure and weight make it a desirable treatment for those with high blood pressure linked to obesity.
• Diabetes and hypertension: If you have both diabetes and uncontrolled hypertension, your risk of cardiovascular disease is extremely significant. Both disorders can be targeted by semaglutide.
• Intolerance to existing blood pressure drugs: Semaglutide offers an alternate therapy option if you have trouble taking conventional blood pressure medications.

Semaglutide, however, has only been explicitly investigated for blood pressure reduction in clinical trials for up to 1 year. Longer-term safety and efficacy remain to be determined.

How Semaglutide Compares to Other Hypertension Drugs

When compared to conventional blood pressure drugs, semaglutide reduces blood pressure to a considerable extent. For instance, semaglutide lowers systolic blood pressure by about 2–11 mmHg, whereas classes such as calcium channel blockers or ACE inhibitors often lower it by 5–15 mmHg on average.

Semaglutide may benefit some patients with more severe hypertension, but it might not be sufficient to decrease blood pressure on its own. It might, however, permit the use of additional blood pressure drugs at reduced dosages.

Semaglutide lowers systolic blood pressure by about 3–6 mmHg, which is comparable to other diabetes medications used to treat blood pressure, such as SGLT2 inhibitors.

Direct comparisons between semaglutide and certain hypertension drugs require further investigation. However, recent data indicates that for many people, its effects are small but significant.