Cardiometabolic & kidney

Effect of incretin-based therapies on blood pressure: a systematic review and meta-analysis

Eur J Prev CardiolPublished Systematic review and meta-analysis of randomised trials

Pooled result · Change in SBPResult — go to the resultReduction 3.4 mmHg 95% CI 2.8–4.0

Authors' conclusion

Incretin-based therapy led to a modest but clinically meaningful BP reduction and lower all-cause mortality in adults with overweight or obesity, without excess in hypoglycaemia or pancreatitis episodes.

Study context

Population
Adults with overweight or obesity
Participants
90,977 adults85 randomized controlled trials (RCTs)
Comparison
Incretin-based therapy vs placebo
Outcome
Change in office SBP
Methodological detailsrandom effects
  • Random effects

Pooled result

Change in SBP

Reduction

3.4 mmHg

95% CI 2.8–4.0

As reported in the abstract

mmHg

SBP reduction with dual receptor agonists
5.1
SBP reduction with triple receptor agonists
6.6

Further pooled results

Change in diastolic BP (DBP)

GLP1-RAs reduced DBP by 0.9 mmHg
95% CI 0.5-1.2

All-cause mortality

All-cause mortality reduced by 18%
RR 0.82, 95% CI 0.76-0.90

Blood pressure (BP) reduction by agonist type (subgroup)

Dual receptor agonists: SBP 5.1 mmHg; DBP 1.8 mmHg
Triple receptor agonists: SBP 6.6 mmHg; DBP 2.1 mmHg
  • Most significant BP reduction

Weight loss and BP reduction (meta-regression)

Higher weight loss significantly associated with greater BP reduction

Safety

OutcomeRR (95% CI)
Hypoglycaemia1.05 (0.83–1.33)
Pancreatitis0.84 (0.61–1.15)

Original publication

Effect of incretin-based therapies on blood pressure: a systematic review and meta-analysis. Eur J Prev Cardiol. Published 3 September 2025. doi:10.1093/eurjpc/zwaf560

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