GLP-1 Medications and Blood Pressure: Benefits, Risks, and More

Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of medications that were initially approved to treat Type 2 diabetes. But since their discovery, the use of GLP-1s has expanded. 

GLP-1s are now FDA-approved to treat many conditions, including obesity, obstructive sleep apnea, and metabolic-associated steatohepatitis. Some of these medications can also help with cardiovascular and renal health.

There’s a growing number of FDA-approved GLP-1 medications, including:

How do GLP-1s work?

GLP-1 medications mimic glucagon-like peptide-1 (GLP-1), a hormone made in the gut. These medications bind to the same receptors in the body, which allows them to produce similar effects. They act on GLP-1 receptors to increase insulin production, slow gastric emptying and help curb appetite. That’s why these medications are so useful in treating Type 2 diabetes and obesity. 

GLP-1 medications also work on GLP-1 receptors in other parts of the body. For instance, in the kidneys, these receptors help regulate how much sodium is reabsorbed or excreted in the urine. And these receptors also play a role in the immune system and help support blood vessel health. GLP-1 medications can interact with these receptors, which can lead to positive kidney and heart health effects.

Are GLP-1s good for your blood pressure?

Yes, there’s evidence that GLP-1 medications can have a positive effect on blood pressure. 

Weight loss can help lower blood pressure. So, by facilitating weight loss, GLP-1s can indirectly lower blood pressure. But weight loss alone doesn’t account for all of the cardiovascular benefits of GLP-1s. 

There are other ways that GLP-1 medications can impact blood pressure:

• Reduced sodium intake: People taking GLP-1s may end up eating less salty foods because they eat less overall. Lower blood pressure is one benefit of a low-sodium diet. 

• Direct action on the kidneys: GLP-1 medications signal to the kidneys to release more sodium into the urine. As sodium leaves the body, blood pressure can go down. 

• Relaxing blood vessels: GLP-1s can also activate receptors on cells inside blood vessels, causing them to vasodilate (relax). And this effect has been shown to improve blood flow.

Are GLP-1s approved to treat high blood pressure?

GLP-1s aren’t FDA-approved for treating high blood pressure. That means that your healthcare team won’t prescribe these medications specifically to treat high blood pressure. 

But some GLP-1 medications are FDA-approved to reduce the risk of major cardiovascular events, such as heart attack and stroke, in certain people with Type 2 diabetes or obesity. These approvals are based on studies showing that GLP-1s can improve several factors that affect heart health, including blood sugar, weight, and blood pressure. 

This means you might still be prescribed a GLP-1 to support your heart health. And, as your overall health improves, your blood pressure may come down, too. So, although GLP-1s aren’t used specifically to treat high blood pressure, they can still have a positive effect on it.

Can you take GLP-1s if you have high blood pressure?

Yes, GLP-1s are safe to take if you have high blood pressure. In fact, these medications may help lower blood pressure through their overall effect on weight and metabolism. 

But GLP-1 medications aren’t safe for everyone. You may not be able to take a GLP-1 medication if you have:

• A personal or family history of medullary thyroid cancer

• Multiple endocrine neoplasia syndrome type 2 (MEN 2)

• A history of anaphylaxis (serious allergic reaction) to GLP-1 medications

• A history of pancreatitis or gastric paresis

You shouldn’t take GLP-1s if you’re pregnant or nursing.

How do GLP-1s affect your heart rate?

GLP-1s can cause an increased heart rate in some people. The change is usually small, only about 2 to 4 beats per minute. But some GLP-1 medications may have a greater effect on heart rate than others.

Researchers are still studying why this happens. One possibility is that GLP-1s activate the sympathetic nervous system, which can raise the heart rate. Another is that they act directly on the heart’s natural pacemaker, called the sinoatrial node.

Even though GLP-1 medications may increase heart rate slightly, there’s no evidence that they increase the risk of arrhythmias (irregular heart rhythms).

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Written by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

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