AHA Scientific Sessions 2026 Abstract · Nov 2, 2026
The Relationship Between Weight Loss and Systolic Blood Pressure Reduction Across GLP-1-Based Therapies: A Meta-Regression
By Moiz A, Samuels A, Filion KB et al.
Background: Glucagon-like peptide-1 (GLP-1) receptor agonists and co-agonists improve body weight and cardiometabolic risk factors among adults with overweight or obesity. However, the relationship between the magnitude of weight loss and systolic blood pressure (SBP) reduction across GLP-1-based therapies remains unclear. Methods: We conducted a systematic review of placebo-controlled randomized controlled trials (RCTs) evaluating GLP-1-based therapies among adults without diabetes. MEDLINE, Embase, and CENTRAL were searched from inception to March 25, 2026. Long-term trials with ≥52 weeks of treatment duration evaluating the highest clinically relevant dose of each therapy were included. Random-effects inverse-variance meta-analyses with restricted maximum likelihood estimation were used to derive pooled estimates for relative weight loss and systolic blood pressure (SBP) reduction across RCTs. Weighted linear regression evaluated the relationship between weight loss and SBP reduction across therapies. Results: We identified 16 RCTs comprising 14,874 participants evaluating liraglutide 3 mg, subcutaneous semaglutide 2.4 mg, oral semaglutide 50 mg, orforglipron 36 mg, tirzepatide 15 mg, cagrilintide-semaglutide (CagriSema) 2.4 mg, and maridebart cafraglutide (MariTide) 420 mg. Pooled estimates for weight loss and SBP reduction for individual therapies across RCTs are shown in Figures 1 and 2 , respectively. Across therapies, weight loss ranged from 4.93% (95% confidence interval [CI] 3.92, 5.93) with liraglutide 3 mg to 18.10% (95% CI 16.80, 19.40) with tirzepatide 15 mg, while SBP reduction ranged from 2.90 mmHg (95% CI 2.22, 3.58) to 9.93 mmHg (95% CI 2.59, 17.27), respectively. Greater weight loss was associated with larger reductions in SBP across therapies (β=0.44 mmHg per 1% weight loss [95% CI 0.21, 0.67]; Figure 3 ). The regression model demonstrated a strong correlation between weight loss magnitude and SBP reduction (R ² =0.82). Conclusions: Across long-term placebo-controlled RCTs of GLP-1-based therapies, greater weight loss was associated with larger reductions in SBP among adults with overweight or obesity.