GLP-1 drugs lower blood pressure a little on average — by roughly 3 to 7 points systolic more than placebo in the trials printed in their US labels — and they raise resting heart rate a little at the same time. None is approved to treat high blood pressure, and the trial registry holds only one small pilot testing one for that purpose. The labels also record the opposite risk: blood pressure falling too far, more often in people already taking blood-pressure medicine.
Everything below was read from the current US prescribing information on DailyMed and from ClinicalTrials.gov on 26 October 2026. Figures are least-squares mean differences from placebo as each label prints them; when we compare across labels, remember the trials enrolled different people for different lengths of time.
Systolic and diastolic changes, by label and trial
The weight-management labels carry a table of "cardiometabolic parameters" for each main trial. The blood-pressure rows:
| Label (trial in label) | Population | Length | Baseline systolic | Systolic vs placebo | Diastolic vs placebo |
|---|---|---|---|---|---|
| Zepbound 5 mg (Study 1) | Obesity, no diabetes | 72 weeks | 123.6 | -5.6 | — |
| Zepbound 10 mg (Study 1) | Obesity, no diabetes | 72 weeks | 123.8 | -6.7 | — |
| Zepbound 15 mg (Study 1) | Obesity, no diabetes | 72 weeks | 123.0 | -6.4 | — |
| Zepbound 10 mg (Study 2) | Obesity + type 2 diabetes | 72 weeks | 130.6 | -4.4 | — |
| Zepbound 15 mg (Study 2) | Obesity + type 2 diabetes | 72 weeks | 130.0 | -5.9 | — |
| Wegovy (Study 1) | Obesity, no diabetes | 68 weeks | 126 | -5.1 | -2.4 |
| Wegovy (Study 2) | Obesity + type 2 diabetes | 68 weeks | 130 | -3.4 | -0.7 |
| Wegovy (Study 3) | Obesity, with intensive behavioural therapy | 68 weeks | 124 | -3.9 | -2.2 |
| Wegovy (Study 5) | Obesity, no diabetes | 104 weeks | 131 | -3.3 | -0.5 |
| Foundayo 5.5 / 9 / 17.2 mg (Trial 1) | Obesity, no diabetes | — | 125.1–125.8 | -4.2 / -3.7 / -4.9 | — |
| Foundayo 5.5 / 9 / 17.2 mg (Trial 2) | Obesity + type 2 diabetes | — | 131.3–132.5 | -2.5 / -2.7 / -3.0 | — |
Sources: ZEPBOUND label v40 (28 Aug 2026), table for Studies 1 and 2; WEGOVY label v19 (18 Jun 2026), tables for Studies 1–3 and 5; FOUNDAYO label v10 (29 Jul 2026), table for Trials 1 and 2. A dash means this page does not report the figure: for Zepbound the label gives diastolic change from baseline (-4.5 to -5.0 mmHg on drug in Study 1 against -0.8 on placebo), and the Foundayo trial length is in its label's clinical studies section.
Three things the table shows:
- The falls are modest and consistent. Every active arm in every trial lowered systolic pressure more than placebo; none by more than about 7 mmHg.
- They are smaller in type 2 diabetes, in each label that tested both groups — the same pattern as weight loss, which is also smaller in those trials. Our Wegovy results and Zepbound results pages give the weight figures beside which these sit.
- Most participants did not have high blood pressure. Baseline systolic was 123–132 mmHg; these are population averages, not results in people with hypertension.
The stop-start test: Wegovy's withdrawal trial
The clearest evidence that the drug, not the trial, moves blood pressure comes from the Wegovy label's Study 4. Everyone took Wegovy for 20 weeks; then half were switched to placebo for 48 weeks. From that point, systolic pressure rose 4.4 mmHg in the placebo group and 0.5 mmHg on Wegovy — a 3.9-point difference. Weight was regained in the placebo group over the same period, so the trial shows the effect fades on stopping; it cannot say how much of it was the weight. What happens to weight after stopping is on our stopping GLP-1 page.
Heart rate rises at the same time
The labels that report blood-pressure falls also report a faster resting pulse:
| Label | Resting heart rate vs placebo | Label wording |
|---|---|---|
| Wegovy | +1 to 4 bpm | Warning: "Monitor heart rate at regular intervals"; discontinue if a sustained increase. In adolescents, 54% vs 39% had a peak increase of 20 bpm or more |
| Saxenda | +2 to 3 bpm (4 to 9 bpm on 24-hour monitoring) | Warning, same monitoring wording; 6% vs 4% had at least one reading above 100 bpm |
| Zepbound | +1 to 3 bpm (placebo: no increase) | Reported in the label's safety section |
| Mounjaro | +2 to 4 bpm (placebo +1) | Sinus tachycardia with ≥15 bpm rise reported; "clinical relevance … is uncertain" |
| Ozempic | +2 to 3 bpm (0.5 and 1 mg) | Reported in the label's safety section |
| Foundayo | +4 to 5 bpm | Tachycardia 3% |
Wegovy's own trial table shows how the two measures move in opposite directions in the same people: in Study 1, systolic pressure -5.1 and heart rate +4.3 bpm against placebo. The labels do not explain the mechanism, and they do not link the heart-rate rise to harm; Wegovy's heart-outcome trial, SELECT, found fewer cardiovascular events on the drug, which is why it carries a heart indication (see the approval timeline).
The opposite risk: blood pressure falling too far
| Label | Hypotension-related reactions, drug vs placebo | On blood-pressure drugs |
|---|---|---|
| Wegovy | 1.3% vs 0.4% (syncope 0.8% vs 0.2%) | More frequent with antihypertensives (no figure) |
| Zepbound | 1.6% vs 0.1% | 2.2% vs 1.2% without |
| Foundayo | 2% vs 0.5% | 4% vs 1% without |
| Saxenda | 1.1% vs 0.5%; systolic below 80 mmHg in 0.1% | — |
Each label ties some cases to vomiting, diarrhoea and dehydration, the same fluid loss behind the drugs' kidney warnings. Wegovy's label adds that adolescents had more hypotension than adults. The practical point the labels make is the interaction: blood pressure that was controlled with medicine before weight loss may be lower after it. Who adjusts that medicine is a question for the prescriber, not for a table. Dizziness and fainting on these drugs are part of the wider record on our GLP-1 side effects page.
What has not been tested
No GLP-1 label carries a hypertension indication, and the registry does not show a programme aimed at one. On 26 October 2026 a ClinicalTrials.gov search for interventional studies naming hypertension returned 8 records for semaglutide and 5 for tirzepatide. Read by title, listed condition and primary outcome, one tests a weight-loss drug as a treatment for raised blood pressure in the arteries: a 60-person pilot (NCT07364175, recruiting, no drug-maker sponsor) comparing standard care with weight-loss drug therapy in obesity-related hypertension, with 24-hour ambulatory systolic pressure as its primary outcome. The rest concern other things that share the word: idiopathic intracranial hypertension (pressure around the brain — two semaglutide trials and one tirzepatide trial), portal hypertension in liver disease, pulmonary arterial hypertension, glaucoma, lung disease, post-bariatric care, a Kazakh cardiovascular programme, and a 112-person pilot of both drugs' effects on blood-vessel flow (NCT07483801, not yet recruiting). The word "hypertension" in a trial title is often not about blood pressure in the usual sense.
So the summary is narrow: in people with obesity, mostly without hypertension, these drugs lowered systolic pressure by a few points on average while raising heart rate by a few beats. Whether that matters for a particular person's blood-pressure treatment is a conversation with the clinician who manages it. The broader picture of heart outcomes is on our Wegovy vs Mounjaro and GLP-1 and kidney disease pages.
Sources
- ZEPBOUND (tirzepatide) prescribing information, DailyMed set 487cd7e7-434c-4925-99fa-aa80b1cc776b, version 40, effective 28 August 2026, dailymed.nlm.nih.gov. Read 2026-10-26.
- WEGOVY (semaglutide) prescribing information, DailyMed set ee06186f-2aa3-4990-a760-757579d8f77b, version 19, effective 18 June 2026, dailymed.nlm.nih.gov. Read 2026-10-26.
- FOUNDAYO (orforglipron) prescribing information, DailyMed set 8ac446c5-feba-474f-a103-23facb9b5c62, version 10, effective 29 July 2026. Read 2026-10-26.
- SAXENDA (liraglutide) prescribing information, DailyMed set 3946d389-0926-4f77-a708-0acb8153b143, version 22, effective 25 February 2026. Read 2026-10-26.
- MOUNJARO (tirzepatide) prescribing information, DailyMed set d2d7da5d-ad07-4228-955f-cf7e355c8cc0, version 40, effective 27 August 2026; OZEMPIC (semaglutide) prescribing information, DailyMed set adec4fd2-6858-4c99-91d4-531f5f2a2d79, version 20, effective 1 June 2026. Read 2026-10-26.
- ClinicalTrials.gov API v2, interventional studies with condition "hypertension" and intervention semaglutide (8 records) or tirzepatide (5 records), each record read, clinicaltrials.gov. Read 2026-10-26.