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 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.
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