Background and Aims Randomized clinical trials (RCTs) assessing semaglutide reported reductions of systolic blood pressure (SBP) in trial populations with baseline blood pressure in the normotensive range. This study aimed to determine whether this SBP reduction is greater in hypertensive groups. Methods Individual patient data (IPD) from three RCTs examining the effect of semaglutide 2.4 mg on body weight over 68 weeks were included. Trial participants were categorized according to a hypertension diagnosis, treatment or baseline measurement (HTN), baseline SBP > 130 mmHg (HTN130) or >140 mmHg (HTN140), and those with apparent resistant hypertension (RH). The primary analysis compared the in-trial change in SBP in the semaglutide and placebo arms. Alterations of anti-hypertensive medications were quantified by treatment intensity score and compared between arms. These analyses were performed using analysis of covariance. Results Overall, 3136 participants were included. The difference in SBP change between the treatment (n = 2109) and placebo (n = 1027) groups was −4.95 mmHg [95% confidence interval (CI) −5.86 to −4.05] overall. This difference was −4.78 mmHg (95% CI −5.97 to −3.59) for HTN, −4.93 mmHg (95% CI −6.75 to −3.11) for HTN130, −4.09 mmHg (95% CI −7.12 to −1.06) for HTN140, and −3.16 mmHg (95% CI −8.69–2.37) for RH. Reduction in SBP was mediated substantially by weight loss. The anti-hypertensive treatment intensity score decreased for those on semaglutide compared to placebo (−0.51; 95% CI −0.71 to −0.32). Conclusions This IPD analysis of three large RCTs found blood pressure reductions with semaglutide in participants with hypertension that were similar to those seen in all trial participants. This finding may in part be due to concurrent reductions to anti-hypertensive medications. These results suggest that semaglutide is a useful adjunctive treatment for patients with hypertension and obesity.

中文翻译：

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索马鲁肽和血压：个体患者数据荟萃分析


背景和目的 评估 semaglutide 的随机临床试验 （RCT） 报告了基线血压在正常血压范围内的试验人群中收缩压 （SBP） 的降低。本研究旨在确定高血压组的 SBP 降低是否更大。方法 纳入来自三项检查 semaglutide 2.4 mg 在 68 周内对体重影响的 RCT 的个体患者数据 （IPD）。试验参与者根据高血压诊断、治疗或基线测量 （HTN）、基线 SBP > 130 mmHg （HTN130） 或 >140 mmHg （HTN140） 以及明显顽固性高血压 （RH） 患者进行分类。主要分析比较了 semaglutide 组和安慰剂组 SBP 的试验中变化。通过治疗强度评分量化抗高血压药物的改变，并在两组之间进行比较。这些分析是使用协方差分析进行的。结果 共纳入 3136 名参与者。治疗组 （n = 2109） 和安慰剂组 （n = 1027） 之间 SBP 变化的差异总体为 -4.95 mmHg [95% 置信区间 （CI） -5.86 至 -4.05]。HTN 的差异为 -4.78 mmHg（95% CI -5.97 至 -3.59），HTN130 的差异为 -4.93 mmHg（95% CI -6.75 至 -3.11），HTN140 的差异为 -4.09 mmHg（95% CI -7.12 至 -1.06），RH 的差异为 -3.16 mmHg（95% CI -8.69-2.37）。SBP 的降低主要由体重减轻介导。与安慰剂相比，索马鲁肽组患者的抗高血压治疗强度评分降低（-0.51;95% CI -0.71 至 -0.32）。结论 这项针对 3 项大型 RCT 的 IPD 分析发现，服用 semaglutide 治疗高血压患者的血压降低情况与所有试验参与者的血压降低情况相似。 这一发现可能部分是由于同时减少抗高血压药物。这些结果表明，索马鲁肽是高血压和肥胖患者的有用辅助治疗。