The effect of subcutaneous semaglutide injection on blood pressure: a systematic review and meta-analysis of randomized controlled trials
In brief
Semaglutide lowers systolic blood pressure by about 3.5 mm Hg
Across seven placebo-controlled trials involving about 20,000 people, subcutaneous semaglutide lowered systolic blood pressure by an average of 3.5 mm Hg. Diastolic pressure fell only slightly, and that result depended on one large study; the findings support a systolic blood pressure benefit, but its practical impact remains to be clarified.
- Journal
- Diabetes research and clinical practice (Q1)
- Published
- 5 November 2026
- Study design
- Systematic review / meta-analysis of RCTs
- Evidence level
- Level 1, High (CEBM 1a)
- Authors
- Navid Ahmadi, Reza Zandi, Mahdiyeh Norouzi, Kousalya Prabahar, Amirhossein Kashi, Abbas Basiri, et al.
- PMID
- 42987980
- DOI
- 10.1016/j.diabres.2026.113646
Why clinicians should know about it
- Picked for Internal Medicine (top studies of the week, 8 November 2026): Randomized-trial synthesis of semaglutide blood-pressure effects
Abstract
Hypertension remains a leading contributor to cardiovascular disease globally. Semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), reduces blood pressure in clinical trials, but the consistency and magnitude of this effect across populations is unclear. We conducted a systematic review and meta-analysis of placebo-controlled randomized trials reporting blood pressure changes in patients receiving subcutaneous semaglutide. MEDLINE, Web of Science, and Embase were searched through December 2025. Pooled weighted mean differences with 95% confidence intervals were calculated using random-effects inverse-variance models. Cochrane's RoB 2.0 assessed risk of bias, and the Grading of recommendations Assessment Development and Evaluation (GRADE) approach was used to evaluate the certainty of the evidence. Our meta-analysis included seven trials with approximately 20,000 patients. Semaglutide reduced systolic blood pressure (SBP) significantly compared with placebo across 11 arms (20,011 participants): weighted mean difference -3.46 mmHg (95% CI: -4.44 to -2.49; I2 = 29.5%; high certainty of evidence). A modest reduction in diastolic blood pressure (DBP) was also observed (-0.56 mmHg, 95% CI: -0.82 to -0.29; I2 = 0.0%; moderate certainty of evidence). However, sensitivity analysis revealed that the DBP effect was dependent on a single large study, with loss of significance upon its exclusion. Subcutaneous semaglutide produces meaningful SBP reduction across diverse patient populations, with minimal DBP changes. Blood pressure improvement represents one component of semaglutide's cardiometabolic benefits.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.