Do GLP-1 agonists like Wegovy (semaglutide) help with high blood pressure?

Semaglutide, currently sold as Wegovy (for obesity) or Ozempic (for diabetes), has been hyped by various more or less well-known public figures as the new miracle weight-loss drug. Novo Nordisk, the maker of Wegovy, even became the most valuable company in Europe in early September 2023 thanks to the miracle injection. The topic is of interest to people with high blood pressure because Wegovy can be prescribed from a BMI of 30. If there are health conditions caused by excess weight, which may include high blood pressure, it can be prescribed from a BMI of 27. At a height of 1.75 m, weighing 82.5 kg already gives a BMI of 27. We have a separate article here about BMI and how to calculate it.

But does semaglutide really live up to the promise of an easy way to lose weight?

Semaglutide for diabetes

Semaglutide was originally developed to treat type 2 diabetes mellitus. This common lifestyle-related form of diabetes is considered acquired, meaning that it is caused by an unhealthy diet and too little exercise, and was formerly called adult-onset diabetes. Today, increasing numbers of younger people and even children are developing this type of diabetes. Semaglutide products are an alternative to existing medications for people with diabetes and can be used when previous options are not tolerated or are insufficiently effective.

Semaglutide for weight loss

The active ingredient has also proven effective for weight loss. Patients treated with this medication were able not only to improve their blood sugar levels but also to lose weight. Therefore, the active ingredient was approved at a higher dose as an adjunct treatment for obesity (a BMI of 30 or more) or overweight (a BMI of 27 or more) with related conditions caused by excess weight, such as high blood pressure. Adjunct treatment means that the medication does not play the main role in therapy but supports basic measures such as dietary changes, exercise and behavior change when these alone are not enough. The medication can be prescribed in these cases, but users must cover the costs themselves. The medication must be injected once a week and will probably need to be used for life, as weight increases again after stopping it. This shows how important lifestyle changes are, because only through them can weight be maintained in the long term.

How does semaglutide work?

Semaglutide is a medicine that mimics the action of the body's own hormone GLP-1. GLP-1 is a peptide hormone that affects blood sugar regulation. It stimulates insulin release and suppresses the release of glucagon, a hormone that raises blood sugar. It also slows stomach emptying and promotes a feeling of fullness. Semaglutide is a synthetic GLP-1 receptor agonist, meaning it binds to and activates the same receptor as GLP-1. Unlike GLP-1, which is quickly broken down in the body, semaglutide has a longer half-life and therefore works for longer. This explains semaglutide's weight-reducing effect, since it reduces appetite and lowers calorie intake. As with other weight-loss drugs, semaglutide can cause side effects, especially in the gastrointestinal tract, such as nausea, diarrhea, etc. The long-term effects and risks of semaglutide have not yet been sufficiently researched.

Semaglutide for high blood pressure

The positive effect on blood pressure, namely the blood-pressure-lowering effect, is attributed to the reduction in body weight. No direct effect on blood pressure has been identified to date. Nevertheless, blood pressure should be monitored because, as described, a reduction in blood pressure can be achieved. This may also make it necessary to adjust high blood pressure medication.

Fundamentally, the key remains changing your own habits, including your diet, physical activity and certain behavioral patterns, to adopt an overall healthier lifestyle, keep the weight off in the long term and protect yourself from health problems caused by excess weight. The active ingredient semaglutide can support these efforts. However, like the many previously hyped weight-loss products before it, it is not a miracle weight-loss treatment.

Other GLP-1 analogues

Besides semaglutide there are other so-called GLP1 analogues. For example, tirzepatide (in Mounjaro), liraglutide (in Saxenda and Victoza) or dulaglutide (in Trulicity). Other active substances include albiglutide, exenatide and lixisenatide. There are already studies examining their effects on blood pressure. For example, a study on tirzepatide was published in February 2024. The results are quite promising, although the effect is at least partly due to weight loss.

Is long-term treatment necessary?

Further studies showed that the effect of so-called weight-loss injections wears off after they are discontinued. Without the medication, the patients treated with it were unable to maintain their reduced weight or the resulting improvements in cardiovascular risk factors. One year after discontinuation, 80% of the participants in one study had regained at least a quarter of the weight they had lost, while most had regained half to three quarters of it, along with their previous health risks. The more weight the participants regained, the more their blood pressure, blood sugar and blood lipid levels deteriorated. Those who regained 75% of the weight they had lost ultimately had levels almost as poor as before treatment.

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/GLP-1-Rezeptor-Agonist
https://www.msdmanuals.com/de-de/profi/klinische-pharmakologie/pharmakodynamik/arzneimittel-rezeptor-wechselwirkungen
https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.123.22022
https://www.pharmazeutische-zeitung.de/ema-entscheidung-mit-beigeschmack-149105/
https://www.aerzteblatt.de/nachrichten/156988/GLP-1-Rezeptoragonisten-zeigen-verschiedene-positive-Effekte-aber-auch-Risiken
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2841273

This article is from Tensana – the leading app since 2011, helping hundreds of thousands of people monitor their blood pressure every day. Our content is based on carefully researched, evidence-based data and is continuously updated (as of 01/2026).

Author Sabine Croci is a qualified medical assistant with many years of experience in internal medicine and cardiology practices as well as outpatient care, and has headed the specialist editorial team at Tensana since 2015. Thanks to her extensive additional qualifications as an emergency medical technician, first responder, and in various areas of therapy and emergency care, she provides well-founded, practical, and reliably verified information.