부산대학교 도서관

Background: Tirzepatide has demonstrated substantial reductions in body weight and in-office blood pressure (BP) in people with obesity with and without type 2 diabetes (T2D). The effects of tirzepatide on ambulatory BP and heart rate (HR) have not been evaluated. We sought to assess the effect of tirzepatide on 24-hour (24h) mean systolic BP (SBP), diastolic BP (DBP) and HR, as measured during 24h ambulatory BP monitoring (ABPM) in people living with obesity without T2D.Methods: In the SURMOUNT-1 ABPM sub-study, participants with a body mass index ≥30, or ≥27 kg/m and at least one weight-related complication (excluding diabetes), with SBP/DBP <140/90 mmHg (and stable antihypertensive therapy if used), were randomly assigned 1:1:1:1 to once-weekly subcutaneous tirzepatide 5, 10, or 15 mg or placebo. The randomization was stratified by pre-diabetes status, country, sex, and use of heart rate controlling medicines at baseline. Participants underwent 24h ABPM at baseline and after 36 weeks of treatment.Results: Among participants randomized in the SURMOUNT-1 trial, 600 were enrolled in the ABPM substudy (69% female; mean age 46 y, BMI 37 kg/m). No clinically significant between-treatment differences were observed in baseline characteristics. Overall, 494 participants had evaluable ABPM data at baseline and post-baseline. Treatment with all tirzepatide doses was associated with significant reductions in 24h SBP at 36 weeks compared with placebo. Participants who received tirzepatide 5 and 10 mg, but not 15 mg, had significantly reduced 24h DBP at 36 weeks versus placebo. An increase in 24h HR was observed with each tirzepatide dose relative to placebo.Conclusion: After 36 weeks of treatment, tirzepatide was associated with statistically significant and clinically meaningful reductions in mean 24h SBP at all doses and of DBP at the two lower doses. Tirzepatide treatment was associated with a dose-dependent increase in the mean 24h HR.