Obesity is a chronic condition that affects more than two in five adults in the United States. The main treatment for obesity is sustained weight loss, which typically involves lifestyle modifications, and may also include certain medications.
Anti-obesity medications are drugs that can aid in weight loss, primarily by curbing appetite, increasing feelings of fullness, or altering fat absorption.
There is a growing demand for weight-loss drugs, and guidelines highlight the role of certain medications, such as glucagon-like peptide-1 (GLP-1) receptor agonists, in treating obesity.
Modern obesity medications may offer an additional cardiovascular benefits beyond weight loss, such as helping to manage high blood pressure, or hypertension.
Obesity and hypertension frequently occur together and significantly increase the risk of cardiovascular disease, stroke, kidney disease, and premature death. Current medical guidelines already recommend weight management as a key strategy for controlling hypertension.
Now, a study presented at the European Congress on Obesity 2026 by researchers from Leiden University Medical Center and University Health Network, in The Netherlands, suggests modern obesity medications may have a larger role in cardiovascular risk reduction than previously appreciated.
Findings from the large meta-analysis — which are yet to appear in a peer-reviewed journal — indicate that greater weight loss achieved with newer anti-obesity medications was closely associated with reductions in systolic blood pressure.
Read more:Heart disease: Perimenopause may be best time to act on risk
Researchers analyzed data from 32 phase 3 clinical trials involving 43,618 adults with overweight or obesity. Participants had an average age of 54 years, and average body mass index (BMI) of 35.5, with nearly 60% living with hypertension and almost 10% living with type 2 diabetes.
There was an even split of male and female participants, the median treatment duration was 66 weeks, and the baseline systolic blood pressure was 128 millimeters of mercury (mm Hg).
Systolic blood pressure refers to the top number in a blood pressure reading and measures the pressure against the artery walls when the heart is pumping blood around the body.
The American Heart Association (AHA) recommends a target systolic blood pressure below 120 mm Hg, with most guidelines defining hypertension as consistent systolic readings of 130 mm Hg or higher.
Across all studies, participants taking obesity medications lost an average of 10.9% of their body weight compared with placebo. This was accompanied by an average reduction of 5.2 mmHg in systolic blood pressure.
Notably, the analysis found that every 1% reduction in body weight was associated with a 0.34 mmHg decrease in systolic blood pressure.
Mir Ali, MD, bariatric surgeon, bariatric medicine specialist and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in Fountain Valley, CA, who was not involved in the study, told Medical News Today he was not surprised by the association.
Read more:GLP-1s for weight loss: Should you really worry about muscle loss?
“These results are not surprising to me; as a bariatric surgeon, I have seen the improvement in hypertension (as well as diabetes and many other conditions) in our post-surgical weight loss patients,” said Ali.
“Any improvement in blood pressure can help reduce morbidity associated with hypertension; furthermore, many patients can have their blood pressure medications reduced with even modest improvements in blood pressure,” he noted.
“These findings again reinforce how obesity contributes to many health conditions including hypertension. Reducing obesity can have a significant impact on improving hypertension as well as many other health conditions.”
– Mir Ali, MD
This relationship between weight loss and blood pressure remained consistent after adjusting for study duration, baseline BMI, sex distribution, and diabetes status.
Additionally, the researchers suggest that around 77% of the variation in blood pressure lowering could be explained by the amount of weight lost.
“Our findings suggest that the blood pressure reductions observed with modern obesity pharmacotherapies are closely linked to the magnitude of weight loss achieved,” lead study author, Marcel Muskiet, MD, told MNT.
Read more:Could creative pursuits help slow down aging?
“Across more than 43,000 participants from phase 3 clinical trials, greater weight reduction was consistently associated with larger decreases in systolic blood pressure. Clinically, this reinforces the concept that treating obesity is not only about weight reduction itself, but also about improving cardiovascular risk factors such as hypertension,” Muskiet noted.
“Importantly, in several of the included trials, background antihypertensive medications were reduced or discontinued more frequently in participants receiving active treatment,” he added.
“This likely attenuated the observed between-group differences in blood pressure, meaning that the true intrinsic blood pressure-lowering potential of these therapies may actually be underestimated in current clinical trial data,” the study author pointed out.
“The magnitude of blood pressure lowering observed with some of these therapies approached that seen with standard antihypertensive medications, highlighting the growing role of weight-centric therapies within cardiovascular risk management for people living with overweight or obesity.”
– Marcel Muskiet, MD
However, the analysis also found that some blood pressure benefits may occur independently of weight loss.
Some evidence suggests these drugs could also directly affect blood vessels, kidney function, and stress signaling pathways in the body, potentially contributing to lower blood pressure independently of weight reduction.
“Although most of the blood pressure reduction appeared attributable to weight loss, our analyses also suggest that additional weight-independent mechanisms may contribute,” Muskiet said.
Read more:Weight loss: What to do if GLP-1s like Wegovy alone aren’t working
“GLP-1 receptor agonists and related multi-hormone therapies may influence blood pressure through several biological pathways, including promoting natriuresis (sodium excretion by the kidney), improving endothelial and vascular function, reducing arterial stiffness, and modulating sympathetic nervous system activity,” he explained.
“In addition, some emerging multi-hormone receptor modulators may interact with hormonal systems involved in blood pressure regulation, including the renin-angiotensin-aldosterone system,” Muskiet detailed.
“However,” he noted, “the precise contribution of these mechanisms remains uncertain and will require dedicated mechanistic and individual patient-level studies.”
The analysis focused on anti-obesity drugs, a growing class of medications designed to improve weight loss and metabolic health by influencing hormones involved in appetite regulation, blood sugar control, and energy balance.
This included glucagon-like peptide-1 receptor agonists (GLP-1RAs), such as Ozempic and Wegovy, and newer multi-hormone receptor modulators (MHRMs). This describes drugs that target multiple metabolic pathways, including GLP-1 and glucose-dependent insulinotropic polypeptide (GIP), such as Zepbound and Mounjaro.
“Overall, therapies associated with the greatest weight loss generally produced the largest blood pressure reductions,” Muskiet highlighted.
Read more:Police vow ‘robust action’ against any proven criminality during Celtic pitch invasion
“In our analysis, tirzepatide showed among the largest reductions in systolic blood pressure, alongside substantial weight loss. Some of the newer multi-hormone receptor modulators also demonstrated pronounced effects, although data remain more limited for several emerging agents,” he added.
“That said, importantly, we would caution against overinterpreting differences between individual agents, as the included trials differed in populations, background therapies, and study design. The overarching pattern was that greater weight loss tended to translate into greater blood pressure reduction across pharmacological classes,” said the study author.
The study authors add that several ongoing trials are investigating whether anti-obesity medications may directly improve cardiovascular and kidney function beyond their effects on body weight.
These include large hypertension-focused clinical trials, as well as studies examining how the drugs affect blood vessels, heart function, and kidney physiology.
They also caution that their study had limitations. The analysis relied on trial-level data rather than individual patient records. This makes it difficult to determine cause and effect. Additionally, blood pressure was not the primary outcome in many of the included studies, so differences in study design may have influenced results.
Still, the consistency of the findings across multiple trials strengthens the overall conclusion that substantial weight loss achieved with newer obesity drugs is linked to clinically meaningful improvements in blood pressure.
