Dual GIP/GLP-1RA reduces ambulatory blood pressure in adults with overweight or obesity
Tirzepatide Reduces 24-Hour Ambulatory Blood Pressure in Adults With Body Mass Index ≥27 kg/m2: SURMOUNT-1 Ambulatory Blood Pressure Monitoring Substudy
Literature - de Lemos JA, Linetzky B, le Roux CW, et al. - Hypertension. 2024 Feb 5. doi: 10.1161/HYPERTENSIONAHA.123.22022Introduction and methods
Background and aim of the study
In SURMOUNT-1, the dual GIP/GLP-1RA tirzepatide reduced body weight and office blood pressure (BP) in patients with obesity [1]. The aim of this substudy of SURMOUNT-1 was the determine the effects of tirzepatide on 24-h ambulatory BP in patients with obesity without T2DM.
Methods
SURMOUNT-1 was a randomized, double-blind, placebo-controlled study that investigated the effects of once-weekly tirzepatide (5, 10 mg, and 15 mg) in 2539 adults with a BMI ≥27 kg/m². A subset of participants underwent 24-h ambulatory BP monitoring (ABPM) at baseline and week 36. Key inclusion criteria for this substudy were BP <140/90 mmHg and stable use of antihypertensive therapy (≥3 months) when applicable. BP was measured every 30 minutes during the day (from 07:00 AM to 22:00 PM) and every 60 minutes during the night (from 22:00 PM to 07:00 AM). Valid ABPM data was obtained for 494 participants.
Main results
- All doses of tirzepatide reduced 24-h systolic BP (SBP) from baseline to 36 weeks compared with placebo. Placebo-adjusted changes in SBP were -7.4 mmHg (95%CI: -10.0 to -4.7) for 5 mg tirzepatide, -10.6 mmHg (95%CI: -13.2 to -8.0) for 10 mg tirzepatide, and -8.0 mmHg (95%CI: -10.6 to -5.4) for 15 mg tirzepatide.
o These differences were detected both during daytime and nighttime, and were not modified by various baseline characteristics, such as age, sex, BMI, antihypertensive medication use, prediabetes hypertension and SBP.
- There was a correlation between changes in SBP and changes in body weight (r=0.31; P<0.0001), and mediation analyses indicated that weight changes mediated 70% (95%CI: 47.0-102.6) of changes in SBP.
- Diastolic BP (DBP) was reduced from baseline to 36 weeks in participants who received 5 mg tirzepatide and 10 mg tirzepatide compared with placebo, but not in participants who received 15 mg tirzepatide. Placebo-adjusted differences in DBP were -2.0 mmHg (95%CI: -3.6 to -0.3), -2.9 mmHg (95%CI: -4.5 to -1.3), and -0.5 mmHg (95%CI: -2.0 to 1.1), respectively.
Conclusion
This substudy of SURMOUNT-1 showed that tirzepatide lowers ambulatory BP in participants with overweight or obesity (BMI ≥27 kg/m²) comparted with placebo, both during daytime and nighttime.
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