CagriSema Reduces Blood Pressure in Adults With Overweight or Obesity: REDEFINE 1.

Summary

In REDEFINE 1, 68 weeks of CagriSema yielded a −10.9/−5.4 mmHg reduction in systolic/diastolic BP versus placebo, doubled the proportion achieving BP targets, and allowed de-escalation of antihypertensives in ~40% of users. Benefits were observed across subgroups, including resistant hypertension.

Key Findings

• BP change at 68 weeks: −10.9/−5.4 mmHg (systolic/diastolic) with CagriSema vs −2.8/−1.7 mmHg with placebo.
• BP target attainment: 63.0% with CagriSema vs 32.0% with placebo.
• Among resistant hypertension at baseline (n=167), BP target attainment 42.0% vs 29.3% (CagriSema vs placebo).
• 39.6% of antihypertensive users on CagriSema decreased or stopped therapy vs 18.8% with placebo.

Clinical Implications

For adults with obesity and elevated BP, CagriSema may provide dual benefits (weight loss and BP lowering), enabling BP target attainment and medication de-escalation. Clinicians should monitor for hypotension and individualize antihypertensive adjustments.

Limitations

• Diabetes excluded; generalizability to patients with diabetes is uncertain.
• Cardiovascular outcomes were not assessed; BP was a secondary endpoint in a weight-loss trial.
• Details on antihypertensive titration protocols are limited.

Future Directions

Evaluate hard cardiovascular outcomes and renal endpoints, assess efficacy in patients with diabetes, and define standardized antihypertensive de-escalation pathways with CagriSema.