Long-term weight-reducing drugs' effects on hypertension and cardiovascular outcomes remain unclear in updated Cochrane review.

Being overweight or obese is strongly linked to hypertension, a major risk factor for cardiovascular mortality and morbidity. While long-term weight management drugs can reduce body weight and blood pressure, their precise effects on patient-relevant outcomes in individuals with essential hypertension have remained largely unclear. This knowledge gap necessitates comprehensive reviews to guide clinical practice and understand the full impact of these interventions.

This updated Cochrane review systematically assessed randomized controlled trials (RCTs) of at least 24 weeks' duration comparing approved long-term weight management drugs to placebo. The target population was non-pregnant adults with essential hypertension. Researchers searched the Cochrane Hypertension Specialised Register, Cochrane CENTRAL, MEDLINE, Embase, and trial registries up to April 22, 2024. Primary outcomes included all-cause mortality, cardiovascular morbidity, and adverse events, while secondary outcomes focused on changes in systolic and diastolic blood pressure and body weight. Risk of bias was assessed using the Cochrane RoB 1 tool, and standard Cochrane methods were applied for meta-analyses, using risk ratios (RRs) for dichotomous and mean differences (MDs) for continuous outcomes.