Long‐term effects of weight‐reducing drugs in people with hypertension

This Cochrane systematic review examined the effects of drugs approved for long-term weight reduction in adults with hypertension. The study included eight randomized controlled trials with approximately 13,000 hypertensive participants taking medications such as orlistat, phentermine/topiramate, naltrexone/bupropion, semaglutide, and tirzepatide. Study duration ranged from six to 48 months. Orlistat probably increases serious adverse events compared to placebo, while its effects on mortality and cardiovascular complications remain uncertain. Phentermine/topiramate had little or no effect on mortality and cardiovascular disease, although evidence is very uncertain. Most studies were funded by the pharmaceutical industry. Overall, the evidence for the effectiveness of these drugs in weight reduction in hypertensive patients is limited and often of low or very low certainty.