The DOI matches its Crossref record; 38 of the 38 references it cites were found in a registry or an index.
Systolic blood pressure reduction with tirzepatide in patients with type 2 diabetes: insights from SURPASS clinical program.
Open accessAbstract
Background: Tirzepatide, a once-weekly glucose-dependent insulinotropic polypeptide/ glucagon-like peptide-1 receptor agonist, is approved in the United States, Europe and Japan for the treatment of type 2 diabetes. Across the SURPASS-1 to -5 clinical studies, tirzepatide 5, 10 and 15 mg demonstrated significant improvements in glycated haemoglobin A1c (HbA1c) (− 1.9 to − 2.6%), body weight (− 6.6 to − 13.9%) and systolic blood pressure (SBP) (− 2.8 to − 12.6 mmHg) at the end of study treatment. Methods: Post-hoc mediation analyses were conducted to evaluate weight-loss dependent and weight-loss independent effects of tirzepatide on SBP reductions across the 5 SURPASS studies. The safety population (all randomized patients who took at least 1 dose of study drug) of each study was analyzed. Additional analyses were conducted at individual study level or pooled across 5 SURPASS trials. Results: The difference in mean SBP change from baseline at 40 weeks (total effect) between the tirzepatide and comparator groups was − 1.3 to − 5.1 mmHg (tirzepatide 5 mg), − 1.7 to − 6.5 mmHg (tirzepatide 10 mg) and − 3.1 to − 11.5 mmHg (tirzepatide 15 mg). These SBP reductions were primarily mediated through weight loss, with different degrees of contributions from weight-loss independent effects across the different trials. In the SURPASS-4 study, which enrolled patients with established cardiovascular disease, weight-loss independent effects explained 33% to 57% of difference in SBP change between tirzepatide and insulin glargine groups. In a pooled analysis of the SURPASS-1 to -5 studies, there was a significant (p < 0.001) but weak correlation (r = 0.18 to 0.22) between change in body weight and SBP. Reductions in SBP with tirzepatide were not dependent on concomitant antihypertensive medications at baseline as similar reductions were observed whether participants were receiving them or not (interaction p = 0.77). The largest SBP reductions were observed in the highest baseline category (> 140 mmHg), while those in the first quartile of baseline SBP category (< 122 mmHg) observed no further decrease in SBP. Conclusions: Tirzepatide-induced SBP reduction was primarily mediated through weight loss, with different degrees of contributions from weight-loss independent effects across the different trials. SBP reduction was not dependent on antihypertensive medication use but dependent on baseline SBP value, alleviating theoretical concerns of hypotension.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The improvement in blood pressure with tirzepatide treatment and subsequent deterioration on withdrawal of tirzepatide is likely related to both weight-dependent and weight-independent mechanisms.
“The improvement in BP with tirzepatide treatment and subsequent deterioration on withdrawal of tirzepatide is likely related to both weight-dependent and weight-independent mechanisms.”
From Cardiometabolic Parameter Change by Weight Regain on Tirzepatide Withdrawal in Adults With Obesity: A Post Hoc Analysis of the SURMOUNT-4 Trial (2026) · cites this paper as [14]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
Liraglutide and Cardiovascular Outcomes in Type 2 Diabetes
Marso, S. P., Daniels, G. H., Brown-Frandsen, K., Kristensen, P., Mann, J. F. E., Nauck, M. A., Nissen, S. E., Pocock, S., Poulter, N. R., Ravn, L. S., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1603827 · Cited by 7,629
Semaglutide and Cardiovascular Outcomes in Patients with Type 2 Diabetes
Marso, S. P., Bain, S. C., Consoli, A., Eliaschewitz, F. G., Jódar, E., Leiter, L. A., Lingvay, I., Rosenstock, J., Seufert, J., Warren, M. L., et al. (2016) · New England Journal of Medicine · doi:10.1056/nejmoa1607141 · Cited by 6,900
Self-citationIncreased oxidative stress in obesity and its impact on metabolic syndrome
Furukawa, S., Fujita, T., Shimabukuro, M., Iwaki, M., Yamada, Y., Nakajima, Y., Nakayama, O., Makishima, M., Matsuda, M., & Shimomura, I. (2004) · Journal of Clinical Investigation · doi:10.1172/jci21625 · Cited by 5,508 · cited 1×
“Excess adiposity, insulin resistance, inflammation and higher oxidative stress are hallmarks of type 2 diabetes and obesity, which are proven to alter endothelial dysfunction and affect haemodynamics resulting in elevated blood pressure [28, 29].”
BackgroundCosentino, F., Grant, P. J., Aboyans, V., Bailey, C. J., Ceriello, A., Delgado, V., Federici, M., Filippatos, G., Grobbee, D. E., Hansen, T. B., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehz486 · Cited by 4,763
Ettehad, D., Emdin, C. A., Kiran, A., Anderson, S. G., Callender, T., Emberson, J., Chalmers, J., Rodgers, A., & Rahimi, K. (2016) · The Lancet · doi:10.1016/s0140-6736(15)01225-8 · Cited by 3,755
Gerstein, H. C., Colhoun, H. M., Dagenais, G. R., Diaz, R., Lakshmanan, M., Pais, P., Probstfield, J., Riesmeyer, J. S., Riddle, M. C., Rydén, L., et al. (2019) · The Lancet · doi:10.1016/s0140-6736(19)31149-3 · Cited by 3,163
Tirzepatide versus Semaglutide Once Weekly in Patients with Type 2 Diabetes
Frías, J. P., Davies, M. J., Rosenstock, J., Pérez Manghi, F. C., Fernández Landó, L., Bergman, B. K., Liu, B., Cui, X., & Brown, K. (2021) · New England Journal of Medicine · doi:10.1056/nejmoa2107519 · Cited by 2,096 · cited 1×
“There was no significant difference between tirzepatide and semaglutide in the SURPASS-2 study at Week 40 in change in heart rate compared to baseline despite higher reduction in HbA1c, weight and SBP [18].”
BackgroundSelf-citation(2000) · PubMed · Cited by 2,095
Hernandez, A. F., Green, J. B., Janmohamed, S., D'Agostino, R. B., Granger, C. B., Jones, N. P., Leiter, L. A., Rosenberg, A. E., Sigmon, K. N., Somerville, M. C., et al. (2018) · The Lancet · doi:10.1016/s0140-6736(18)32261-x · Cited by 1,829
Self-citationDiabetes, Hypertension, and Cardiovascular Disease: Clinical Insights and Vascular Mechanisms
Petrie, J. R., Guzik, T. J., & Touyz, R. M. (2018) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2017.12.005 · Cited by 1,787 · cited 11×
“Some glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have demonstrated CV benefits, [7–10] and generally a neutral to modest reduction in BP, making them a preferred treatment option in patients with T2D with indicators of high-risk of established atherosclerotic CV disease [11].”
BackgroundInfluential9. Pharmacologic Approaches to Glycemic Treatment: Standards of Medical Care in Diabetes—2022
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s009 · Cited by 1,555
Rosenstock, J., Wysham, C., Frías, J. P., Kaneko, S., Lee, C. J., Fernández Landó, L., Mao, H., Cui, X., Karanikas, C. A., & Thieu, V. T. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01324-6 · Cited by 1,080
Self-citationRahimi, K., Bidel, Z., Nazarzadeh, M., Copland, E., Canoy, D., Ramakrishnan, R., Pinho-Gomes, A.-C., Woodward, M., Adler, A., Agodoa, L., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00590-0 · Cited by 1,074
10. Cardiovascular Disease and Risk Management: Standards of Medical Care in Diabetes—2022
American Diabetes Association Professional Practice Committee (2022) · Diabetes Care · doi:10.2337/dc22-s010 · Cited by 869
Blood Pressure Lowering in Type 2 Diabetes: A Systematic Review and Meta-analysis
Emdin, C. A., Rahimi, K., Neal, B., Callender, T., Perkovic, V., & Patel, A. (2015) · JAMA · doi:10.1001/jama.2014.18574 · Cited by 854
Diabetes and hypertension: a position statement by the American Diabetes Association
de Boer, I. H., Bangalore, S., Benetos, A., Davis, A. M., Michos, E. D., Muntner, P., Rossing, P., Zoungas, S., & Bakris, G. (2017) · Diabetes Care · doi:10.2337/dci17-0026 · Cited by 714 · cited 1×
“Hypertension is a strong risk factor for microvascular and macrovascular diabetic complications, including retinopathy, nephropathy and atherosclerotic cardiovascular disease [3, 4].”
BackgroundDel Prato, S., Kahn, S. E., Pavo, I., Weerakkody, G. J., Yang, Z., Doupis, J., Aizenberg, D., Wynne, A. G., Riesmeyer, J. S., Heine, R. J., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)02188-7 · Cited by 684
Ludvik, B., Giorgino, F., Jódar, E., Frias, J. P., Fernández Landó, L., Brown, K., Bray, R., & Rodríguez, Á. (2021) · The Lancet · doi:10.1016/s0140-6736(21)01443-4 · Cited by 639
Self-citationDahl, D., Onishi, Y., Norwood, P., Huh, R., Bray, R., Patel, H., & Rodríguez, Á. (2022) · JAMA · doi:10.1001/jama.2022.0078 · Cited by 597
Self-citationGastaldelli, A., Cusi, K., Fernández Landó, L., Bray, R., Brouwers, B., & Rodríguez, Á. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00070-5 · Cited by 513 · cited 1×
“It is not surprising that robust weight loss, reduction in liver and abdominal fat [30] and improvement in insulin sensitivity [31] associated with tirzepatide treatment may likely affect this key pathophysiological state associated with elevated BP in this population.”
BackgroundNauck, M. A., & D‘Alessio, D. A. (2022) · Cardiovascular Diabetology · doi:10.1186/s12933-022-01604-7 · Cited by 407
Brunström, M., & Carlberg, B. (2016) · BMJ · doi:10.1136/bmj.i717 · Cited by 375
Tirzepatide cardiovascular event risk assessment: A pre-specified meta-analysis
Sattar, N., McGuire, D. K., Pavo, I., Weerakkody, G. J., Nishiyama, H., Wiese, R. J., & Zoungas, S. (2022) · Nature Medicine · doi:10.1038/s41591-022-01707-4 · Cited by 346 · cited 10×
“Tirzepatide has a safety profile consistent with that of GLP-1 RAs, with mild to moderate gastrointestinal adverse events (AEs) mostly reported during the dose escalation period which decreased over time.”
BackgroundInfluentialHeerspink, H. J. L., Sattar, N., Pavo, I., Haupt, A., Duffin, K. L., Yang, Z., Wiese, R. J., Tuttle, K. R., & Cherney, D. Z. I. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00243-1 · Cited by 306 · cited 1×
“In a post-hoc analysis of SURPASS-4 data, tirzepatide slowed the rate of decline in eGFR, showed clinically meaningful improvement in albuminuria and significantly lowered occurrence of the composite kidney outcomes compared to insulin glargine which may be related to SBP lowering [40].”
MethodSironi, A. M., Gastaldelli, A., Mari, A., Ciociaro, D., Postano, V., Buzzigoli, E., Ghione, S., Turchi, S., Lombardi, M., & Ferrannini, E. (2004) · Hypertension · doi:10.1161/01.hyp.0000137982.10191.0a · Cited by 273
Heise, T., Mari, A., DeVries, J. H., Urva, S., Li, J., Pratt, E. J., Coskun, T., Thomas, M. K., Mather, K. J., Haupt, A., et al. (2022) · The Lancet Diabetes & Endocrinology · doi:10.1016/s2213-8587(22)00085-7 · Cited by 268 · cited 1×
“It is not surprising that robust weight loss, reduction in liver and abdominal fat [30] and improvement in insulin sensitivity [31] associated with tirzepatide treatment may likely affect this key pathophysiological state associated with elevated BP in this population.”
BackgroundHall, M. E., Cohen, J. B., Ard, J. D., Egan, B. M., Hall, J. E., Lavie, C. J., Ma, J., Ndumele, C. E., Schauer, P. R., & Shimbo, D. (2021) · Hypertension · doi:10.1161/hyp.0000000000000202 · Cited by 259
Gaspari, T. A., Liu, H., Welungoda, I., Hu, Y., Widdop, R. E., Knudsen, L. B., Simpson, R. W., & Dear, A. E. (2011) · Diabetes and Vascular Disease Research · doi:10.1177/1479164111404257 · Cited by 203 · cited 1×
“Natriuresis [32], direct vasodilation [33], reductions in sympathetic nervous system activity [34], extracellular volume and midregional-pro-atrial natriuretic peptide (proANP) [33, 35] are potential direct mechanisms for GLP-1 RAs leading to SBP lowering.”
BackgroundKatout, M., Zhu, H., Rutsky, J., Shah, P., Brook, R. D., Zhong, J., & Rajagopalan, S. (2013) · American Journal of Hypertension · doi:10.1093/ajh/hpt196 · Cited by 142 · cited 1×
“In a meta-analysis conducted across 33 randomized studies, the authors evaluated GLP-1 RAs, liraglutide and exenatide, using random-effect analysis and concluded that these GLP-1 RAs induced a small but significant change in SBP that appeared to be independent of the degree of weight loss and SBP values at baseline [2…”
MethodHeuvelman, V. D., Van Raalte, D. H., & Smits, M. M. (2020) · Cardiovascular Research · doi:10.1093/cvr/cvz323 · Cited by 106 · cited 1×
“Several mechanisms have been postulated for elevation in heart rate with GLP-1 RAs, such as reflex tachycardia, increase in sympathetic nervous system activity and direct sino-atrial node action but none have been clinically proven yet [39].”
BackgroundFonseca, V. A., DeVries, J. H., Henry, R. R., Donsmark, M., Thomsen, H. F., & Plutzky, J. (2014) · Journal of Diabetes and its Complications · doi:10.1016/j.jdiacomp.2014.01.009 · Cited by 96 · cited 10×
“Tirzepatide has a safety profile consistent with that of GLP-1 RAs, with mild to moderate gastrointestinal adverse events (AEs) mostly reported during the dose escalation period which decreased over time.”
ResultInfluentialArambewela, M. H., Somasundaram, N. P., Jayasekara, H. B. P. R., Kumbukage, M. P., Jayasena, P. M. S., Chandrasekara, C. M. P. H., Fernando, K. R. A. S., & Kusumsiri, D. P. (2018) · Journal of Diabetes Research · doi:10.1155/2018/4504287 · Cited by 78 · cited 1×
“Hypertension is a strong risk factor for microvascular and macrovascular diabetic complications, including retinopathy, nephropathy and atherosclerotic cardiovascular disease [3, 4].”
BackgroundTime course and mechanisms of the anti‐hypertensive and renal effects of liraglutide treatment
von Scholten, B. J., Lajer, M., Goetze, J. P., Persson, F., & Rossing, P. (2015) · Diabetic Medicine · doi:10.1111/dme.12594 · Cited by 73 · cited 1×
“Natriuresis [32], direct vasodilation [33], reductions in sympathetic nervous system activity [34], extracellular volume and midregional-pro-atrial natriuretic peptide (proANP) [33, 35] are potential direct mechanisms for GLP-1 RAs leading to SBP lowering.”
Backgroundvan Ruiten, C. C., Smits, M. M., Kok, M. D., Serné, E. H., van Raalte, D. H., Kramer, M. H. H., Nieuwdorp, M., & IJzerman, R. G. (2022) · Cardiovascular Diabetology · doi:10.1186/s12933-022-01492-x · Cited by 57 · cited 1×
“Natriuresis [32], direct vasodilation [33], reductions in sympathetic nervous system activity [34], extracellular volume and midregional-pro-atrial natriuretic peptide (proANP) [33, 35] are potential direct mechanisms for GLP-1 RAs leading to SBP lowering.”
BackgroundUssher, J. R., Greenwell, A. A., Nguyen, M.-A., & Mulvihill, E. E. (2022) · Diabetes · doi:10.2337/dbi20-0049 · Cited by 51 · cited 1×
“Natriuresis [32], direct vasodilation [33], reductions in sympathetic nervous system activity [34], extracellular volume and midregional-pro-atrial natriuretic peptide (proANP) [33, 35] are potential direct mechanisms for GLP-1 RAs leading to SBP lowering.”
BackgroundWijkman, M. O., Dena, M., Dahlqvist, S., Sofizadeh, S., Hirsch, I. B., Tuomilehto, J. O., Mårtensson, J., Torffvit, O., Imberg, H., Saeed, A., et al. (2018) · Journal of Clinical Hypertension · doi:10.1111/jch.13447 · Cited by 18 · cited 1×
“This finding is also consistent with that reported with liraglutide [36].”
ResultHeimbürger, S. M. N., Hoe, B., Nielsen, C. N., Bergmann, N. C., Hartmann, B., Holst, J. J., Størling, J., Vilsbøll, T., Dejgaard, T. F., Christensen, M., et al. (2020) · Diabetes · doi:10.2337/db20-351-or · Cited by 4
Flagged first, then by citations
Research works printed but not linked: 2
- Hall ME, Faha M, Cohen JB, Ard JD, Egan BM, Hall JE, Lavie CJ, Ma J, Ndumele CE, Schauer PR, Shimbo D, on behalf of the American Heart Association Council on Hypertension; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Lifestyle and Cardiometabolic Health; and Stroke Council. Weight-loss strategies for prevention and treatment of hypertension: a scientific statement from the American Heart Association. Hypertension. 2021;78(5):e38–50. · DOI
- Sorum N, et al. GIP infusion acutely decreases blood pressure and increases heart rate in men with type 2 diabetes, concomitantly with increased proatrial natriuretic peptide levels. In: Diabetologia. 2022; Springer, USA.
Cited by
Sorted by citations
Clinical Outcomes of Tirzepatide or GLP-1 Receptor Agonists in Individuals With Type 2 Diabetes
Chuang, M.-H., Chen, J.-Y., Wang, H.-Y., Jiang, Z.-H., & Wu, V.-C. (2024) · JAMA Network Open · doi:10.1001/jamanetworkopen.2024.27258 · Cited by 133
Randomized Trial of Effect of Bariatric Surgery on Blood Pressure After 5 Years
Schiavon, C. A., Cavalcanti, A. B., de Oliveira, J. D., Machado, R. H. V., Santucci, E. V., Santos, R. N., Oliveira, J. S., Damiani, L. P., Paranhos, D. J. C., Halpern, H., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.11.032 · Cited by 83
Beyond glycemia: Comparing tirzepatide to GLP-1 analogues
Andraos, J., Muhar, H. K., & Smith, S. R. (2023) · Reviews in Endocrine and Metabolic Disorders · doi:10.1007/s11154-023-09825-1 · Cited by 50
Caruso, I., & Giorgino, F. (2024) · Endocrine · doi:10.1007/s12020-024-03757-9 · Cited by 55
Horn, D. B., Linetzky, B., Davies, M. J., Laffin, L. J., Wang, H., Murphy, M. A., Zimner-Rapuch, S., Lau, E., Arad, A. D., & Lee, C. J. (2026) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2025.6112 · Cited by 50
Yang, D., Chen, Y., Chen, Y.-K., Zeng, Y.-L., & Ling, Z. (2025) · Cardiovascular Research · doi:10.1093/cvr/cvaf033 · Cited by 26
Perspectives on weight control in diabetes – Tirzepatide
Várkonyi, T. T., Pósa, A., Pávó, N., & Pavo, I. J. (2023) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2023.110770 · Cited by 20
“with tirzepatide, additional mechanisms could also contribute: improvement in insulin sensitivity, lipoproteins, and cardiovascular biomarkers as well as the reduction in visceral and liver fat [81].”
BackgroundRudzki, G., Knop-Chodyła, K., Piasecka, Z., Kochanowska-Mazurek, A., Głaz, A., Wesołek, E., & Woźniak, M. M. (2024) · Pharmaceuticals · doi:10.3390/ph17080987 · Cited by 18
“Tirzepatide also showed beneficial effects on the cardiovascular system by causing a reduction in the endothelial damage marker ICAM-1 (Intercellular Adhesion Molecule 1), the proinflammatory cytokine YKL-40 (chitinase-3-like protein 1) and blood pressure [84].”
BackgroundMechanisms and treatment of obesity-related hypertension—Part 2: Treatments
Parvanova, A. I., Abbate, M., Reseghetti, E., & Ruggenenti, P. L. (2025) · Clinical Kidney Journal · doi:10.1093/ckj/sfaf035 · Cited by 17
“Most studies found an association between BP reduction and WL, without excluding WL-independent mechanisms related to GLP-1RA/GIP activity [165 , 166 ].”
InfluentialLyons, S. A., & Beaudry, J. L. (2023) · Endocrinology · doi:10.1210/endocr/bqad153 · Cited by 16
Weight Loss Therapies and Hypertension Benefits
Katsi, V. K., Manta, E., Fragoulis, C., & Tsioufis, K. P. (2024) · Biomedicines · doi:10.3390/biomedicines12102293 · Cited by 16
“The authors claimed that weight reduction was the primary factor mediating changes in SBP, with a modest (r = 0.18–0.22) but significant ( p 0.001) association seen between SBP and body weight changes [66].”
BackgroundInfluentialArd, J. D., Neeland, I. J., Rothberg, A. E., Chilton, R. J., de Luis, D., Cohen, S. S., & Johansen, O. E. (2024) · Diabetes, Obesity and Metabolism · doi:10.1111/dom.15392 · Cited by 12
“…(i.e. semaglutide and tirzepatide), can lead to significantly larger weight loss, as well as influence CV risk factors more profoundly, 32,33 and even lead to a reduction in ASCVD events in people with obesity, 34 a long-term study comparing weight loss via caloric restriction through an…”
BackgroundLiarakos, A. L., & Koliaki, C. C. (2023) · Biomedicines · doi:10.3390/biomedicines11071875 · Cited by 16
“Of note, SBP reduction was not dependent on antihypertensive medication use but rather on baseline SBP, which is reassuring regarding the theoretical risks of hypotension.”
BackgroundInfluentialNicholls, S. J., Tofé, S., le Roux, C. W., D’Alessio, D. A., Wiese, R. J., Pavo, I., Brown, K., Weerakkody, G. J., Zeytinoglu, M., & Romera, I. C. (2024) · Cardiovascular Diabetology · doi:10.1186/s12933-024-02147-9 · Cited by 11
“Overall, our results align with other post hoc analyses with tirzepatide, which showed a greater clinical benefit, greater improvements in HbA1c and other cardiometabolic measures, with greater weight loss [41, 54].”
ResultSelf-citationZeitler, P. S., Galindo, R. J., Davies, M. J., Bergman, B. K., Thieu, V. T., Nicolay, C., Allen, S. E., Heine, R. J., & Lee, C. J. (2024) · Diabetes Care · doi:10.2337/dc23-2356 · Cited by 18
Feldman-Billard, S. (2025) · Diabetes & Metabolism · doi:10.1016/j.diabet.2025.101664 · Cited by 12
Goldenberg, R., Teoh, H., & Verma, S. (2023) · Current Opinion in Cardiology · doi:10.1097/hco.0000000000001084 · Cited by 11
“6mmHg, and while the decline in SBP was mainly mediated through body weight loss, there were different degrees of body weight loss-independent effects on SBP across the trials [39].”
BackgroundOXM-104, a potential candidate for the treatment of obesity, NASH and type 2 diabetes
Melander, S. A., Kayed, A., Andreassen, K. V., Karsdal, M. A., & Henriksen, K. (2023) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2023.176215 · Cited by 11
Ma, J., Liu, M., Wang, R., Du, L., & Ji, L. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15446 · Cited by 12
“25 However, further studies are needed to fully understand the effect of tirzepatide on SBP and DBP.”
BackgroundUrva, S., Levine, J. A., Schneck, K. B., & Tang, C. C. (2024) · Current Medical Research and Opinion · doi:10.1080/03007995.2024.2322072 · Cited by 11
“42,43 When switching between drugs, it would be expected that these beneficial cardiometabolic improvements would be maintained.”
BackgroundCharacteristics and Dosing Patterns of Tirzepatide Users with Type 2 Diabetes in the United States
Mody, R., Desai, K. R., Teng, C., Reznor, G., Stockbower, G. E., Grabner, M., & Benneyworth, B. D. (2025) · Diabetes Therapy · doi:10.1007/s13300-024-01684-6 · Cited by 13
Insights into the Mechanism of Action of Tirzepatide: A Narrative Review
Galindo, R. J., CHENG, A. Y. Y., Longuet, C., Ai, M., Coşkun, T., Malik, R., Peleshok, J. C., Levine, J. A., & Dunn, J. P. (2025) · Diabetes Therapy · doi:10.1007/s13300-025-01804-w · Cited by 23
“Post hoc mediation analysis across SURPASS-1 through SURPASS-5 found that decreases in systolic blood pressure (ranging from 1.3 mmHg to 11.5 mmHg across the tirze-patide doses) were primarily mediated through weight loss [91].”
InfluentialKido, K., Carey, B., Caccamo, M. A., Bianco, C. M., & Sokos, G. G. (2023) · Journal of the American Pharmacists Association · doi:10.1016/j.japh.2023.09.011 · Cited by 10
Kunutsor, S. K., Seidu, S., Dey, R. S., Baidoo, I. K., & Oulhaj, A. (2024) · Scandinavian Cardiovascular Journal · doi:10.1080/14017431.2024.2418086 · Cited by 10
“The blood pressure lowering effects of GLP-1RAs may also be via several pathways including natriuresis and weight loss [18,19].”
Chee, Y. J., & Dalan, R. (2024) · Biomedicines · doi:10.3390/biomedicines12071386 · Cited by 7
“Another phase II trial to characterize the dose range and escalation involved 411 patients with T2DM and compared to semaglutide 1 mg weekly found that a dose-dependent absolute reduction in HbA1c up to nearly 1.7% after 16 weeks, as compared to approximately 1.5% for semaglutide [178].”
BackgroundInfluentialAbdul‐Hafez, H. A., Awashra, A., Bdir, S., Saife, S., Salah, Q., Barbarawi, M., Swaileh, T., Emara, A., Elgendy, M. S., & Shubietah, A. R. M. (2026) · Endocrinology Diabetes & Metabolism · doi:10.1002/edm2.70152 · Cited by 7
“Taken together, BP lowering plus improvements in weight and lipids likely reduce HF and stroke risk and improve HFpEF symptoms, with the greatest benefit in patients starting with higher SBP and obesity-related haemodynamic load [19, 20, 24].”
Mimura, H., Oura, T., Chin, R., Takeuchi, M., Fujihara, K., & Sone, H. (2025) · Journal of Diabetes Investigation · doi:10.1111/jdi.14395 · Cited by 6
“In terms of WL-UA observations regarding tirzepatide and SBP, multiple potential mechanisms have been proposed 22 , including natriuresis, vasodilation, and changes in autonomic nervous system activity 26 – 28 .”
Aydos, D., Aksoy, Z. B., Ünal, M. A., Akçalı, K. C., Bitirim, C. V., & Turan, B. (2025) · Cardiovascular Diabetology · doi:10.1186/s12933-025-02828-z · Cited by 7
“However, this drug has its beneficial effect by affecting the internalization of these receptors and consequently the release of insulin in pancreatic β-cells [19, 25].”
Caturano, A., Nilo, D., Lorenzo, G. D., Rocco, M. P., Tagliaferri, G., Piacevole, A., Donnarumma, M., Iadicicco, I., Moretto, S. M., Acierno, C., et al. (2025) · Reviews in Cardiovascular Medicine · doi:10.31083/rcm43143 · Cited by 9
Tirzepatide: unveiling a new dawn in dual-targeted diabetes and obesity management
Rabbani, S. A., El‐Tanani, M., Matalka, I. I., Rangraze, I. R., Aljabali, A. A. A., Khan, M. A., & Tambuwala, M. M. (2024) · Expert Review of Endocrinology & Metabolism · doi:10.1080/17446651.2024.2395540 · Cited by 8
“TZP caused a significant reduction in systolic blood pressure [134,135], owing to its vasodilatory effect, extracellular volume reduction, natriuresis and weight loss effect.”
Lee, E. M., Cho, I., Kang, H., Kim, K., Kim, D., Kim, J. H., Kim, H., Kim, H. C., Kim, H. J., Koh, E. S., et al. (2026) · Clinical Hypertension · doi:10.5646/ch.2026.32.e31 · Cited by 7
Wang, J., Kang, J., Peng, T., Chen, H., Chen, S., & Lee, M. (2025) · Clinical Obesity · doi:10.1111/cob.70036 · Cited by 5
“In terms of blood pressure, a meta-analysis suggested that tirze-patide's blood pressure-lowering effect seems to correlate with weight loss [34].”
Blood Pressure-Lowering Effects of SGLT2 Inhibitors and GLP-1 Receptor Agonists
Siddiqi, A. K., Khan, M. S., Kulkarni, A., Hall, M. E., Böhm, M., Dı́ez, J., & Butler, J. (2025) · Current Hypertension Reports · doi:10.1007/s11906-025-01342-7 · Cited by 4
Ala, M., Jafari, R. M., Dehpour, A. R., & Poursalehian, M. (2024) · International Journal of Obesity · doi:10.1038/s41366-024-01621-4 · Cited by 4
“In addition, in the presence of more clinical trials, meta-analyses may help identify factors predicting a greater response to either insulin or tirzepatide.”
Larsen, A. T., Melander, S. A., Mohamed, K. E., Petersen, E. A., Benmarce, M., Karsdal, M. A., & Henriksen, K. (2025) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2025.118388 · Cited by 3
Tanaka, M., & Itoh, H. (2025) · Hypertension Research · doi:10.1038/s41440-025-02418-2 · Cited by 3
“As well as favorable hypoglycemic and BW losing effects, this novel co-agonist has shown to lower BP signi fi cantly [18].”
InfluentialTirzepatide – a new analogue of incretin hormones
Anglart, G., Janik, L., & Dettlaff, K. (2023) · Farmacja Polska · doi:10.32383/farmpol/174068 · Cited by 3
Tirzepatid - a new hope in the treatment of obesity and a new antidiabetic drug
Prosecký, R., & Vítovec, J. (2023) · Klinická farmakologie a farmacie · doi:10.36290/far.2023.012 · Cited by 2
Vázquez, L. A., Tofé, S., Bellido, D., Botella-Serrano, M., Soto-González, A., Mezquita‐Raya, P., Delgado, E., Fajardo, C., Morales, C., Causanilles, A., et al. (2024) · Diabetes Therapy · doi:10.1007/s13300-024-01587-6 · Cited by 2
“The induced BP reduction was primarily mediated through weight loss, with different degrees of contribu‑ tions from weight loss‑independent effects, and independent from the use of antihypertensive medication [45, 46].”
BackgroundGrenet, G., Gougeon, A., Salzwedel, D. M., Jauca, C. D., & Wright, J. M. (2025) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd016144 · Cited by 1
Ectopic, hepatic GLP-1R agonism enhances the weight loss efficacy of GLP-1 analogues
Douros, J. D., Capozzi, M. E., Novikoff, A., Mokrosiński, J., DUBOIS, B. N., Stock, J., Rohlfs, R., Anderson, M., Jedrzejcyk, D. J., Poulsen, S., et al. (2026) · Molecular Metabolism · doi:10.1016/j.molmet.2026.102327 · Cited by 1
“Unlike their mono-and dual-incretin receptor agonist predecessors, which improve CV function [10 — 13], development of GcgR activating compounds has been challenged by the increased HR and arrhythmia induced by chronic GcgR agonism [2,3,14,15].”
Gómez-Martín, Á., Marqués, P., Recatalá, C. A., Vea, À., Domingo, E., Alabadí, B., Real, J. T., Sanz, M., & Piqueras, L. (2026) · Pharmacological Research · doi:10.1016/j.phrs.2026.108321 · Cited by 1
Khan, I., Meenakshi, S., Abubakar, M., Kumar, N., Gaikwad, V. L., Rai, A., & Murti, K. (2026) · Endocrine · doi:10.1007/s12020-026-04686-5 · Cited by 1
Rapid Gastric emptying in spontaneously hypertensive rats
Salman, U. A., Schwartz, J. G., McMahan, C. A., Michalek, J. E., & Phillips, W. T. (2023) · Journal of Hypertension · doi:10.1097/hjh.0000000000003640 · Cited by 1
Tirzépatide : les leçons du programme clinique SURPASS. Au-delà de l’équilibre glycémique
Guerci, B. (2023) · Médecine des Maladies Métaboliques · doi:10.1016/j.mmm.2023.06.003 · Cited by 1
Ali, F., & Farzand, M. (2025) · Kidney News · doi:10.62716/kn.000092024
Antihypertensive Medications in Patients With Weight Loss
Manian, F. A. (2025) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2024.8118
Aydos, D., Aksoy, Z. B., Ünal, M. A., Akçalı, K. C., Bitirim, C. V., & Turan, B. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.04.09.648025
苗, 娜. (2025) · Advances in Clinical Medicine · doi:10.12677/acm.2025.1592463
Nicholls, S. J., Tofé, S., le Roux, C. W., D’Alessio, D. A., Wiese, R. J., Pavo, I. J., Brown, K. E., Weerakkody, G. J., Zeytinoglu, M., & Romera, I. (2024) · Figshare · doi:10.6084/m9.figshare.25201920
Self-citationKim, H. (2026) · Electrolytes & Blood Pressure · doi:10.5049/ebp.2026.24.e6
“…of five clinical trials of tirzepatide reported dose-dependent SBP and body weight reductions, and maximum dose of tirzepatide was associated with SBP reduction of up to 11 mmHg in patient with obesity, indicating that SBP reduction of tirzepatide was primarily mediated by weight loss [54].”
Kitamoto, T., Yoshino, M., Shingaki, T., Oura, T., Valderas, E. G., & Dunn, J. P. (2026) · Current Medical Research and Opinion · doi:10.1080/03007995.2026.2695047
“In terms of additional endpoints, both tirzepatide and semaglutide have shown promising effects on blood pressure regulation and lipid profiles in previous studies 32–35 .”
Abdullah‐Zawawi, M., Apparow, S., & Jalal, M. I. A. (2026) · Egyptian Journal of Medical Human Genetics · doi:10.1186/s43042-026-00894-w
“In clinical trials, tirzepatide lowered systolic blood pressure by an additional 5 to 6 mmHg compared to a GLP-1 agonist, likely via weight loss and improved insulin sensitivity [38].”
Laffin, L. J., Schlaich, M. P., Hall, M. E., Xie, C. C., Rao, G. S., Rettiganti, M., Dennehy, E. B., & Linetzky, B. (2026) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2026.101783
“For example, in post hoc analyses of the SURMOUNT-1 trial and SURPASS clinical program, treatment with the GIP/GLP-1 RA tirzepatide was associated with reduced BP, and the underlying mechanisms appear to be both weight-dependent and weight-independent [16 – 18].”
Effect of tirzepatide and semaglutide on blood pressure: A systematic review and meta-analysis
Chen, Q.-X., Xiao-yu, Z., Wu, Q., Xie, J.-J., Xu, Y., Teng, F., & Guo, M. (2026) · Endocrine · doi:10.1007/s12020-026-04757-7
“Although randomized trials indicate that these therapies reduce blood pressure, existing meta-analyses have predominantly focused on continuous variables to evaluate efficacy, such as mean reductions in clinic blood pressure [ 13–16 ].”
Metadata
- Authors
- Lingvay, I., Mosenzon, O., Brown, K., Cui, X., O’Neill, C., Fernández Landó, L., & Patel, H.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Hebrew University of Jerusalem (IL)
- Eli Lilly (United States) (US)
- Corresponding author
- Patel, Hiren
- Venue
- Cardiovascular Diabetology
- Published
- 2023-03-24
- Volume
- 22
- Issue
- 1
- Pages
- 66-66
- ISSN
- 1475-2840 (ISSN-L)
- PMC
- PMC10039543
- OpenAlex
- W4360827095
- Cited by
- 55
- References
- 38
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 15 · 2023: 12
- FWCI
- 11.28
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Cardiovascular Diabetology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Eli Lilly and Company
- Topics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- tirzepatide, type 2 diabetes, systolic blood pressure reduction, SURPASS trials, weight loss, mediation analysis, GIP/GLP-1 receptor agonist, antihypertensive drugs, cardiovascular disease, insulin glargine, body weight, glycated haemoglobin A1c
- MeSH terms
- Glucagon-Like Peptide-1 Receptor, Glucagon-Like Peptide-1 Receptor Agonists, Tirzepatide, Antihypertensive Agents, Blood Pressure, Body Weight, Diabetes Mellitus, Type 2, Gastric Inhibitory Polypeptide, Humans, Hypoglycemic Agents, Hypotension, Weight Loss
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
