Semaglutide’s cardiovascular benefits spanned blood pressure groups
For major cardiovascular events, hazard ratios—relative event rates over time—were 0.80 with controlled blood pressure and 0.87 with uncontrolled pressure, versus placebo.
Placebo-controlled, registered NCT03914326
Limit: The blood pressure comparison was an exploratory subgroup analysis conducted after the trial
Edited by Boris Djordjevic · AgingResearch.News
The randomized SOUL trial enrolled 9,650 people aged 50 or older with type 2 diabetes and cardiovascular disease involving fatty buildup in arteries, chronic kidney disease or both. Participants received oral semaglutide or placebo.
Researchers conducted an exploratory analysis of 9,646 participants with blood pressure data. They classified blood pressure below 130/80 mmHg as controlled; 2,767 participants met that definition, while 6,879 did not. Semaglutide was associated with lower risk of a first nonfatal heart attack, nonfatal stroke or cardiovascular death in both groups. Hazard ratios below 1 favored semaglutide. The association did not differ significantly by initial blood pressure control. After 104 weeks, semaglutide also modestly reduced systolic pressure, the upper blood pressure number, compared with placebo in both groups. It did not reduce diastolic pressure, the lower number.
Why it matters
Preventing heart attacks and strokes matters as people with type 2 diabetes grow older. This analysis addressed whether initial blood pressure control helps distinguish who may gain cardiovascular benefits from semaglutide.
Caveats
These were exploratory subgroup analyses conducted after the trial, not proof that effects were identical across groups. Participants were at least 50 and had diabetes plus cardiovascular or kidney disease; the conference abstract did not report the dose, absolute event rates or harms.
The paper
Imperial College London; University of Texas Southwestern Medical Center
ESC Congress 2026 Abstract, Oct 26, 2026
Presented at ESC Congress 2026
