GLP-1s reduce incident hypertension risk for adolescents with obesity
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Key takeaways:
- GLP-1s were tied to lower risk for developing primary hypertension over 5 and 10 years for adolescents vs. other anti-obesity medications.
- Analyses of other obesity-related comorbidities are underway.
SAN ANTONIO — In adolescents with obesity, GLP-1 receptor agonists were associated with lower risk for incident hypertension development 5 and 10 years after initiation vs. other anti-obesity medications, a speaker reported.
“Here in the U.S., about 20% of adolescents have obesity, and prevalence varies significantly by state. We also know that non-Hispanic Black and Hispanic adolescents face disproportionately high risk for both obesity and severe obesity. This is likely due to many of the same factors that drive the other multitude of health disparities in the U.S., including systemic racism, wealth inequities, political marginalization and a broken food system,” Shradha Chhabria, MD, MPH, a pediatrics resident at The Case Western Reserve University/University Hospitals Cleveland Medical Center, said during a presentation at ObesityWeek. “Primary hypertension is one of the obesity-related comorbidities that we are increasingly seeing in this population, about one in four adolescents with obesity currently carries this diagnosis.”
Chhabria and colleagues identified data from adolescents aged 10 to 19 years with obesity from TriNetX, a large retrospective multicenter database. All participants were prescribed either GLP-1 receptor agonists containing semaglutide (Wegovy, Novo Nordisk), liraglutide (Saxenda, Novo Nordisk) and tirzepatide (Zepbound, Eli Lilly) or other anti-obesity medications such as orlistat (Xenical, Roche; Alli, GlaxoSmithKline), metformin, phentermine/topiramate (Qsymia, Vivus) or naltrexone/bupropion (Contrave, Nalpropion Pharmaceuticals). Researchers followed these two cohorts 5 and 10 years after pharmacotherapy initiation and calculated risk ratios to compare risk for incident hypertension.
The database included 1,925 adolescents (mean age, 15.4 years; mean baseline BMI, 41.7 kg/m2) in the GLP-1 receptor agonist group and 22,742 (mean age, 13.3 years; mean baseline BMI, 37.9 kg/m2) in the other anti-obesity medications group. After propensity-score matching, both groups included 1,923 adolescents, and the groups did not differ in baseline characteristics except for BMI, which was higher in the GLP-1 group (P < .001).
GLP-1 receptor agonist use was associated with a lower risk for developing primary hypertension over 5 years (2.12% vs. 3.96%; RR = 0.54; 95% CI, 0.36-0.81) and 10 years (2.12% vs. 4.08%; RR = 0.52; 95% CI, 0.35-0.78) vs. other anti-obesity medications, the researchers found.
According to Chhabria, the group is currently in the process of conducting additional analyses on other obesity-related comorbidities to prevent obstructive sleep apnea, type 2 diabetes and hyperlipidemia.
“These findings are consistent with the rapidly expanding body of evidence supporting the incredible efficacy of GLP-1 receptor agonists for the treatment of adolescents with obesity,” Chhabria said. “The existing literature clearly shows the efficacy in treating obesity itself, but our study contributes to the evidence by also supporting superiority over other anti-obesity medications in preventing the development of obesity-related comorbidities in the long term in this at-risk population.”
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Chhabria S, et al. Oral-024. Presented at: ObesityWeek; Nov. 3-6, 2024; San Antonio.
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