Does a GLP-1 lower blood pressure?
Yes, by a few points, and mostly through the weight you lose. In the STEP 1 trial, semaglutide (Wegovy) took 5.1 points more off systolic (the top number) than placebo. In a trial of tirzepatide (Zepbound) measured on a 24-hour monitor, the drop was 7 to 11 points more than placebo, depending on the dose.
A lot of people start a GLP-1 for weight and notice their blood pressure coming down on the cuff. That’s what the trials found too, and it fits what’s known about weight. Across trials, blood pressure falls by about 1 point for every 2.2 lb lost, and these drugs take off a lot of weight.
| Trial | Who | Weight lost | Systolic, against placebo |
|---|---|---|---|
| STEP 1, semaglutide 2.4 mg, 68 weeks | 1,961 adults with overweight or obesity, no diabetes | 14.9 percent, against 2.4 on placebo | 5.1 points lower in the clinic |
| SURMOUNT-1 substudy, tirzepatide, 36 weeks | 600 adults with a BMI of 27 or more, no diabetes, starting under 140/90 | Not given in the substudy | 7.4, 10.6 and 8.0 points lower at 5, 10 and 15 mg, over 24 hours |
In the tirzepatide study, about 70 percent of the drop in blood pressure was explained by the weight lost, and the drop held during the night as well as the day. Heart rate went up by about 2 to 5 beats a minute at 36 weeks. The 2025 US guideline mentions GLP-1 medicines as a possible addition for some people with high blood pressure and overweight or obesity.
If you take blood pressure medicine too
As the weight comes off, your blood pressure may fall far enough that your usual dose is too much. Tell your prescriber if you feel dizzy when you stand up, or your home numbers drop well below your usual. Don’t stop or cut a blood pressure medicine on your own. A home week every month or two gives your prescriber the numbers to adjust it.
A GLP-1 doesn’t replace the plate, salt and walking, which lower blood pressure in their own right (how to lower it naturally). bodyfat.guide has more on how GLP-1 drugs work for weight.
4 sources
- Wilding et al., STEP 1, once-weekly semaglutide in adults with overweight or obesity, NEJM, 2021, as summarized by Wiki Journal Clubwikijournalclub.org
- de Lemos JA et al., Tirzepatide reduces 24-hour ambulatory blood pressure in adults with body mass index of 27 or more, SURMOUNT-1 substudy, Hypertension, 2024ahajournals.org
- American College of Cardiology, New high blood pressure guideline emphasizes prevention, early treatment to reduce CVD risk, press release on the 2025 AHA/ACC guideline, 14 August 2025acc.org
- Neter et al., weight reduction and blood pressure, Hypertension, 2003researchinformation.umcutrecht.nl
