Semaglutide and tirzepatide lower blood pressure, and tirzepatide does so more strongly. In the 24-hour blood pressure measurement of SURMOUNT-1, tirzepatide lowered systolic pressure by 7.4 to 10.6 mm Hg more than placebo. Semaglutide 2.4 mg lowered it by an average of 4.95 mm Hg more than placebo in three large trials. Below we collect these results and explain where the fall in blood pressure comes from.
How strongly does tirzepatide lower blood pressure?
This was shown most precisely by 24-hour blood pressure monitoring in 600 participants of SURMOUNT-1. The device measured blood pressure every 30 minutes during the day and every hour at night for a whole day. The measurement was taken at the start and after 36 weeks, and the results were published in 2024 in the journal Hypertension.
| Tirzepatide dose | Fall in systolic pressure compared with placebo after 36 weeks |
|---|---|
| 5 mg | 7.4 mm Hg |
| 10 mg | 10.6 mm Hg |
| 15 mg | 8.0 mm Hg |
Average systolic pressure at the start was 124.6 mm Hg, so most participants did not have high blood pressure. The fall was seen both during the day and at night. It worked similarly regardless of age, sex, BMI and whether someone was already treated for high blood pressure.
How many people on tirzepatide had normal blood pressure?
After 72 weeks, 58.0 percent of people on tirzepatide and 35.2 percent on placebo had normal blood pressure. This comes from a separate analysis of the whole SURMOUNT-1 trial, published in 2024 in the journal Heart. In it, systolic pressure fell by 6.8 mm Hg more than on placebo, and diastolic by 4.2 mm Hg more.
The fall was fast in the first 24 weeks, and then blood pressure stayed at a lower level until the end of the trial. The effect was similar in all groups of starting blood pressure. The whole distribution of blood pressures in the group shifted towards lower values.
Does tirzepatide lower blood pressure in diabetes?
Yes, and it does so most strongly in people with the highest blood pressure. This was shown by an analysis of five SURPASS trials in people with type 2 diabetes, published in 2023 in Cardiovascular Diabetology. By the end of treatment systolic pressure had fallen by 2.8 to 12.6 mm Hg.
- High pressure at the start: the greatest fall was seen in people with systolic pressure above 140 mm Hg.
- Low pressure at the start: in people with pressure below 122 mm Hg there was no further fall.
- Blood pressure medicines: the fall was similar in people who took them and in those who did not.
The authors write that this pattern eases theoretical concerns about blood pressure falling too low. Pressure fell where it was high, and where it was low it stayed unchanged. In SURPASS-4, in people with heart disease, part of the fall in blood pressure did not depend on weight loss.
How strongly does semaglutide lower blood pressure?
Semaglutide 2.4 mg lowered systolic pressure by an average of 4.95 mm Hg more than placebo. This was the result of an analysis of data from 3136 patients in three trials lasting 68 weeks. It was published in 2024 in the European Heart Journal.
| Group in the analysis | Fall in systolic pressure compared with placebo |
|---|---|
| All participants | 4.95 mm Hg |
| People with high blood pressure | 4.78 mm Hg |
| Systolic pressure above 130 mm Hg | 4.93 mm Hg |
| Systolic pressure above 140 mm Hg | 4.09 mm Hg |
In people with high blood pressure the fall was similar to that in all participants. Some of them may also have been able to reduce their blood pressure medicines. The intensity of blood pressure treatment fell more on semaglutide than on placebo.
In STEP 4, people who continued semaglutide had systolic pressure 3.9 mm Hg lower than people switched to placebo. The guide on semaglutide after stopping describes this trial in more detail.
Where does the fall in blood pressure come from?
The fall in blood pressure results mostly from weight loss. In the SURMOUNT-1 analysis, body weight explained 68 percent of the fall in systolic pressure and 71 percent of the fall in diastolic pressure. In the 24-hour measurement it was about 70 percent.
For semaglutide, the authors of the patient-data analysis also write that the fall in blood pressure resulted largely from weight loss. The remaining part of the effect is not fully explained.
There is no direct comparison of the two medicines on blood pressure, but there is an indirect comparison of STEP 1 and SURMOUNT-1 from September 2026. In it, tirzepatide at 10 and 15 mg gave a greater weight loss than semaglutide 2.4 mg. Diastolic pressure was lower at every tirzepatide dose, by 1.3 to 2.4 mm Hg. The work was prepared by researchers linked to the maker of tirzepatide.
What to watch out for with low blood pressure?
With tirzepatide, episodes of blood pressure that was too low did occur, though rarely. A meta-analysis of 32 trials with 47,332 participants, published in August 2026, calculated this precisely. The risk of events related to low blood pressure was about 2.5 times higher on tirzepatide than in the comparison groups, most of all at higher doses.
The same meta-analysis showed the other side of the coin. Events related to high blood pressure were 60 percent less frequent on tirzepatide. Semaglutide had a neutral profile here, with no significant effect on either type of event. People with low blood pressure or taking blood pressure medicines would do well to measure their blood pressure regularly during treatment.
What about retatrutide?
Retatrutide also lowers blood pressure. A meta-analysis of trials from June 2026 found an average fall in systolic pressure of 6.79 mm Hg and in diastolic pressure of 2.46 mm Hg. Total cholesterol, LDL cholesterol and triglycerides also fell, while HDL cholesterol did not change.
With retatrutide too, low blood pressure needs to be kept in mind. In TRIUMPH-2, low blood pressure was reported by 1 percent of people at 4 mg, 5 percent at 9 mg and 6 percent at 12 mg. In the placebo group it was under 1 percent. The results of retatrutide over the months are described in the guide on retatrutide results.
Where to buy semaglutide and tirzepatide?
The shop offers semaglutide 3 mg Bio-Peptide for 90 EUR, in stock. Tirzepatide comes in three versions: 20 mg Bio-Peptide for 200 EUR in stock, 20 mg Genheal for 200 EUR on backorder and 40 mg Nouveaux in a pen for 350 EUR in stock.
The products in the shop are material for laboratory research, not the medicines Wegovy or Mounjaro. Treatment of high blood pressure is managed by a doctor, and no research material replaces it. Other benefits of both molecules beyond weight, namely the heart, kidneys, sleep and liver, are described in the guide semaglutide and tirzepatide beyond weight loss.
Frequently asked questions
Does tirzepatide lower blood pressure?
Yes, in the 24-hour measurement in SURMOUNT-1 it lowered systolic pressure by 7.4 to 10.6 mm Hg more than placebo after 36 weeks, depending on the dose.
Does semaglutide lower blood pressure?
Yes, in an analysis of three trials semaglutide 2.4 mg lowered systolic pressure by an average of 4.95 mm Hg more than placebo. In people with high blood pressure the fall was similar.
Which medicine lowers blood pressure more?
In separate trials tirzepatide worked more strongly. A 2026 meta-analysis showed 60 percent fewer events related to high blood pressure with it, while semaglutide had a neutral profile.
Why do these medicines lower blood pressure?
Mainly through weight loss. In SURMOUNT-1 body weight explained 68 percent of the fall in systolic pressure and 71 percent of the fall in diastolic pressure.
Can tirzepatide lower blood pressure too much?
This happened rarely, but more often than on placebo, especially at higher doses. People with low blood pressure would do well to measure it regularly.
Sources
- de Lemos JA, Linetzky B, le Roux CW et al. Tirzepatide Reduces 24-Hour Ambulatory Blood Pressure in Adults With Body Mass Index of 27 kg/m2 or more: SURMOUNT-1 Ambulatory Blood Pressure Monitoring Substudy. Hypertension, 2024, 81(4): e41-e43. https://doi.org/10.1161/HYPERTENSIONAHA.123.22022
- Krumholz HM, de Lemos JA, Sattar N et al. Tirzepatide and blood pressure reduction: stratified analyses of the SURMOUNT-1 randomised controlled trial. Heart, 2024, 110(19): 1165-1171. https://doi.org/10.1136/heartjnl-2024-324170
- Lingvay I, Mosenzon O, Brown K et al. Systolic blood pressure reduction with tirzepatide in patients with type 2 diabetes: insights from SURPASS clinical program. Cardiovascular Diabetology, 2023, 22(1): 66. https://doi.org/10.1186/s12933-023-01797-5
- Kennedy C, Hayes P, Cicero AFG et al. Semaglutide and blood pressure: an individual patient data meta-analysis. European Heart Journal, 2024, 45(38): 4124-4134. https://doi.org/10.1093/eurheartj/ehae564
- Chen QX, Zhou XY, Wu Q et al. Effect of tirzepatide and semaglutide on blood pressure: A systematic review and meta-analysis. Endocrine, 2026, 91(1): 275. https://doi.org/10.1007/s12020-026-04757-7
- Rubino D, Abrahamsson N, Davies M et al. Effect of Continued Weekly Subcutaneous Semaglutide vs Placebo on Weight Loss Maintenance in Adults With Overweight or Obesity: The STEP 4 Randomized Clinical Trial. JAMA, 2021, 325(14): 1414-1425. https://doi.org/10.1001/jama.2021.3224
- Ciudin A, Johansson E, Zimner-Rapuch S et al. Indirect comparative efficacy and safety of tirzepatide vs semaglutide for the treatment of obesity or overweight in patients without type 2 diabetes. International Journal of Obesity, 2026. https://doi.org/10.1038/s41366-026-02229-6
- Simental-Mendía LE, Barragán-Zúñiga LJ, Reyes-Avitia V. Effect of Retatrutide, a Novel Triple Receptor Agonist, on Blood Pressure and Lipid Levels: A Systematic Review and Meta-analysis of Randomized Controlled Trials. High Blood Pressure and Cardiovascular Prevention, 2026, 33(5): 503-516. https://doi.org/10.1007/s40292-026-00812-6
- Bellido V, le Roux CW, Ekinci EI et al. Retatrutide in adults with obesity and type 2 diabetes (TRIUMPH-2). The Lancet, 2026. https://doi.org/10.1016/S0140-6736(26)01861-1