How does Ozempic affect blood pressure?
Ozempic (semaglutide) is more likely to lower blood pressure than to increase it and several trials of semaglutide have shown significant reductions in blood pressure in people who had normal blood pressure to start with, or slightly elevated blood pressure to start with. There is a lack of studies on people with high baseline blood pressure, but it seems likely that their blood pressure would also decrease with Ozempic.
Blood pressure reduction does seem to correlate with weight loss; however, there also seem to be some other, as yet unknown, non-weight loss mechanisms also contributing to the weight loss.
Older adults may be more susceptible to these blood pressure decreases because they are more susceptible to orthostatic hypotension – that is the sudden drop in blood pressure when standing up from sitting or lying down
Summary of Research
Across the Sustain 1-5 trials (n=3,918), greater reductions in systolic BP were related to greater weight loss. However, it also appeared that other, unknown weight loss mechanisms were also contributing to weight loss.
- An average decrease in SBP of 2.6 to 5.1 mmHg and 2.7 to 7.3 mmHg with semaglutide 0.5 and 1.0 mg, respectively, vs −1.0 to −2.3 mmHg with comparators was reported in participants who had a baseline BP or 128.8–134.8 mmHg).
- In the >4.0 kg WL category, the mean change in SBP was −3.0 to −6.8 and −4.4 to −9.3 mmHg with semaglutide 0.5 and 1.0 mg, respectively, vs −4.0 to +1.1 mmHg with comparators.
- In the 0–4.0 kg WL category, the mean change in SBP was −2.0 to −4.8 mmHg and −0.7 to −5.2 mmHg with semaglutide 0.5 and 1.0 mg, respectively, vs -2.1 to -4.2 mmHg with comparators.
- For subjects with no WL/BW gain, the mean change in SBP was −1.5 to +1.5 mmHg and −5.4 to +1.0 mmHg with semaglutide 0.5 and 1.0 mg, respectively, vs −1.0 to +1.1 mmHg with comparators.
An overall decrease in blood pressure was reported in a review of 6 high-quality RCTS (n=4744) that compared semaglutide to a placebo (an inactive treatment) (Kennedy, 2023). The mean BP before initiation of semaglutide was in the normotensive range (usually quoted as 115-120/70-75 mmHg), and most participants were female and white. Studies ranged in length from 48 to 104 weeks.
- The mean difference in systolic BP was −4.83 mmHg (95% CI: −5.65 to −4.02)
- The mean difference in diastolic BP was −2.45 mmHg (95% CI: −3.65 to −1.24).
- The study concluded that a significant reduction in blood pressure was evident following semaglutide treatment in normotensive populations without diabetes. This study did not report on the effects semaglutide had on BP in those with high blood pressure to start with.
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References
- Kennedy C, Hayes P, Salama S, Hennessy M, Fogacci F. The Effect of Semaglutide on Blood Pressure in Patients without Diabetes: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2023; 12(3):772. https://doi.org/10.3390/jcm12030772
- Warren, M., Chaykin, L., Trachtenbarg, D., Nayak, G., Wijayasinghe, N., & Cariou, B. (2018). Semaglutide as a therapeutic option for elderly patients with type 2 diabetes: A pooled analysis of the SUSTAIN 1-5 trials. Diabetes, obesity & metabolism, 20(9), 2291–2297. https://doi.org/10.1111/dom.13331
- S Bain, M Davies, F K Knop, H Vrazic, T V Skjoth, I Lingvay, P1878.Reduction in systolic blood pressure with semaglutide treatment is not due to weight loss alone: data from SUSTAIN 1-5, European Heart Journal, Volume 39, Issue suppl_1, August 2018, ehy565.P1878, https://doi.org/10.1093/eurheartj/ehy565.P1878
Read next
How do Ozempic, Mounjaro, Wegovy, Zepbound compare for weight loss?
Ozempic, Mounjaro, Wegovy and Zepbound can all lead to long-term weight loss, but only Wegovy and Zepbound are approved by the FDA for this use. In studies, Zepbound has led to a 21% weight loss in adults using the highest dose, while Wegovy has led to about a 15% weight loss.
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How long does it take for Ozempic to work?
Your blood glucose (sugar) levels should start to fully decline within the first week after you start using Ozempic (semaglutide) at your regular dose. However, the full effect can take 8 weeks or longer, as this is a long-acting medication that is injected only once per week. Continue reading
Wegovy vs Ozempic: Which is Right for You?
Both Wegovy and Ozempic contain semaglutide, but Wegovy is prescribed for long-term weight management while Ozempic is used to control blood sugar levels in type 2 diabetes and help protect kidney function. They both lower the risk for heart-related complications, but they differ in other approved uses, doses, target populations and costs. Continue reading
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