Cardiometabolic & kidneyMeta-analysis
Effect of incretin-based therapies on blood pressure: a systematic review and meta-analysis
- Systematic review and meta-analysis of randomised trials
- random effects
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 adults · 85 randomized controlled trials (RCTs)
- Comparison
- Incretin-based therapy vs placebo
- Outcome
- Change in office SBP
Pooled result
Change in SBP
Reduction
3.4 mmHg
95% CI 2.8–4.0
GLP1-RAs vs Placebo
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
| Outcome | RR (95% CI) | |
|---|---|---|
| Hypoglycaemia | 1.05 (0.83–1.33) | |
| Pancreatitis | 0.84 (0.61–1.15) | |
| 0.512Relative risk (log scale) |
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
Summarised from the published abstract; every number is checked against it