2nd Edition of International Obesity and Metabolism Conference 2026

Abstract

Background: Tirzepatide induces substantial weight loss and may influence vascular parameters, but real-world data on blood pressure (BP) and pulse changes in normotensive patients with overweight and obese remain limited.

Objective: To evaluate the effects of tirzepatide on BP and pulse in patient with overweight/obese naïve to antihypertensive and GLP-1 receptor agonist therapy.

Methods: This retrospective observational study included 33 adults (BMI >25 kg/m²) from two tertiary Indian centres (Jul–Dec 2025) treated with tirzepatide for 16 weeks. BP and pulse were recorded at baseline and follow-up using the best of three measurements. Median baseline systolic BP, diastolic BP, pulse, and weight were 130 mmHg, 74 mmHg, 90 bpm, and 89 kg, respectively.

Result: Among 33 patients, blood pressure and pulse rate responses varied significantly. Systolic Blood Pressure (SBP) showed a decrease in 18 patients (55%), an increase in 13 patients (39%), and remained unchanged in 2 (6%). Diastolic Blood Pressure (DBP) decreased in 11 patients (33%) and increased in 22 patients (67%). Pulse rate decreased in 21 patients (64%) and increased in 12 patients (36%).
In the 0–5% weight-loss group (n=19), SBP decreased in 47%, increased in 47%, and remained unchanged in 5%. DBP decreased in 47% and increased in 53%, while pulse rate decreased in 63% and increased in 37%.
For the 6–10% weight-loss group (n=7), SBP decreased in 57% and increased in 43%. DBP decreased in 14% and increased in 86%, with pulse rate decreasing in 71% and increasing in 29%.
In the >10% weight-loss group (n=7), SBP decreased in 71%, increased in 14%, and remained unchanged in 14%. DBP decreased in 14% and increased in 86%, while pulse rate decreased in 57% and increased in 43%. Post-treatment, most patients had SBP within the 111–130 mmHg range, with only four patients maintaining SBP >140 mmHg after treatment.

Conclusion: Tirzepatide demonstrated variable effects on blood pressure and pulse rate in overweight and obese patients. Greater weight loss was generally associated with improved systolic blood pressure reduction, particularly in the >10% weight-loss group. Pulse rate decreased in most patients; however, diastolic blood pressure increased in a majority across all groups. Additionally, some patients experienced increases in systolic blood pressure and pulse rate despite treatment. These highlight significant interindividual variability and the need for larger prospective studies to better evaluate its hemodynamic effects.