Does Wegovy (Semaglutide) help with high blood pressure?

Semaglutide, currently marketed as Wegovy (obesity treatment) or Ozempic (diabetes treatment), is being hyped by various more or less well-known public figures as the new miracle drug for weight loss. Novo Nordisk, the manufacturer of Wegovy, became the most valuable company in Europe thanks to the miracle injection in early September 2023. For those with hypertension, the topic is interesting, as Wegovy can be prescribed with a BMI of 30. If there are weight-related diseases present, which can include high blood pressure, prescription is possible with a BMI of 27. At a height of 1.75 m, one already has a BMI of 27 with 82.5 kg. We have a separate article on BMI and its calculation here.

But does Semaglutide really live up to the promises of an easy way to lose weight?

Semaglutide in Diabetes

The active ingredient Semaglutide was originally developed for the treatment of type 2 diabetes mellitus. This form of diabetes is considered a typical civilization disease and is regarded as acquired, caused by an unhealthy diet and insufficient exercise, and was formerly referred to as age-related diabetes. Nowadays, younger people and even children are increasingly affected by this form of diabetes. Semaglutide preparations are an alternative to existing medications for diabetics that can be used when there are intolerances or insufficient effects from previous options.

Semaglutide for Weight Loss

The active ingredient has also proven effective in weight reduction. Patients treated with this medication were able not only to improve their blood sugar levels but also to lose weight. Therefore, the active ingredient has been approved in higher doses for the accompanying treatment of obesity (with a BMI of 30 or more) or overweight (BMI of 27 or more) with accompanying diseases caused by overweight, such as high blood pressure. Accompanying treatment means that the medication does not play the main role in therapy but supports fundamental measures such as dietary changes, exercise, and behavioral changes when these alone are insufficient. The medication can be prescribed in these cases, but the costs must be borne by the user. The medication must be injected once a week and is likely to be used for life, as weight tends to increase again after discontinuation. This shows how important lifestyle changes are, as only through them can weight be maintained in the long term.

How does Semaglutide work?

Semaglutide is a medication that mimics the action of the body's own hormone GLP-1. GLP-1 is a peptide hormone that influences blood sugar regulation. It stimulates the release of insulin and inhibits the release of glucagon, a hormone that raises blood sugar levels. Additionally, it delays gastric emptying and promotes the feeling of fullness. Semaglutide is a synthetic GLP-1 receptor agonist, meaning it binds to the same receptor as GLP-1 and activates it. Unlike GLP-1, which is quickly broken down in the body, Semaglutide has a longer half-life and thus acts longer. This explains the weight-reducing effect of Semaglutide, as it suppresses appetite and reduces calorie intake. As with other weight loss medications, Semaglutide can also cause side effects, particularly in the gastrointestinal area, such as nausea, diarrhea, etc. The long-term effects and risks of Semaglutide have not yet been sufficiently researched.

Semaglutide against High Blood Pressure

The positive influence on blood pressure, that is, the blood pressure-lowering effect, is attributed to the reduced body weight. A direct effect on blood pressure has not yet been discovered.

Fundamentally, the change in one's behavior, both in terms of diet and exercise and certain behavioral patterns towards an overall healthier lifestyle, remains essential to keep weight down permanently and to protect against the consequences of overweight. The active ingredient Semaglutide can support these efforts. However, like many previously hyped weight loss products, it is not a miracle cure for weight loss.

Other GLP-1 Analogs

In addition to Semaglutide, there are other so-called GLP-1 analogs. For example, Tirzepatide (in Mounjaro), Liraglutide (in Saxenda and Victoza), or Dulaglutide (in Trulicity). Other active ingredients include Albiglutide, Exenatide, and Lixisenatide. There are already studies examining their effects on blood pressure. For instance, a study on Tirzepatide was published in February 2024. The results are quite promising, although the effect is at least partially attributable to weight loss.

Sources:

https://www.aerzteblatt.de/nachrichten/145222/Die-Medikamente-muessen-mehr-Effekte-zeigen-als-nur-den-Gewichtsverlust
https://www.aerzteblatt.de/archiv/212727/Typ-2-Diabetes-Glukosesenkung-mit-Herzschutz
https://adipositas-gesellschaft.de/adipositas-medikamente-fragen-und-antworten/
https://www.nejm.org/doi/full/10.1056/NEJMoa1901118
https://www.nejm.org/doi/full/10.1056/nejmoa1607141
https://www.ema.europa.eu/en/documents/overview/wegovy-epar-medicine-overview_de.pdf
https://www.aerzteblatt.de/nachrichten/145163/Adipositas-Semaglutid-senkt-Zahl-der-Herz-Kreislauf-Ereignisse
https://www.pharmazeutische-zeitung.de/wegovy-ab-heute-in-deutschland-erhaeltlich-141242/
https://www.aerzteblatt.de/archiv/196360/Adipositastherapie-Abnehmen-mittels-Medikament
https://flexikon.doccheck.com/de-de/GLP-1-Rezeptor-Agonist
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https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.22022
https://www.pharmazeutische-zeitung.de/ema-entscheidung-mit-beigeschmack-149105/

By Sabine Croci. This article is medically reviewed. Last updated by Horst Klier (8/2024).
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