OBJECTIVE: The aim was to systematically evaluate the effect of semaglutide on blood pressure in obese populations using meta-analysis methods.
METHODS: Randomized controlled trials on the effect of semaglutide on blood pressure regulation published from the inception of the databases to October 2024 were searched for in PubMed, Embase, the Cochrane Library, and Web of Science. Stata software was used for statistical analysis of the outcome measures in all included studies. Egger's test was applied to assess the risk of publication bias.
RESULTS: A total of 22 studies involving 15,347 participants were included in this meta-analysis. The results showed that, compared to the control group, the semaglutide group significantly reduced systolic blood pressure (SBP) (mean difference [MD] - 2.90, 95% confidence interval [CI] - 3.70 to - 2.11; P < 0.01) and diastolic blood pressure (DBP) (MD - 0.86, 95% CI - 1.34 to - 0.38; P < 0.01). Further subgroup analysis revealed that, compared to diabetic populations, semaglutide had a more significant reduction in SBP (- 1.87, 95% CI - 2.67 to - 1.06, vs - 5.02, 95% CI - 6.10 to - 3.94) and DBP (- 0.43, 95% CI - 0.89 to 0.02, vs - 1.96, 95% CI - 3.12 to - 0.80) in non-diabetic populations. The higher dose of semaglutide (2.4 mg) was found to significantly lower SBP (MD - 4.31, 95% CI - 5.18 to - 3.44) and DBP (MD - 1.84, 95% CI - 2.70 to - 0.98), although mild heterogeneity was present. Sensitivity analysis showed that the exclusion of any single study did not significantly affect the final results.
CONCLUSION: Current evidence suggests that semaglutide can lower SBP and DBP, and increasing the dosage can enhance the blood pressure-lowering effect.