Achieving the triple endpoint of body weight reduction thresholds, systolic blood pressure reduction ≥5 mmHg and non-HDL cholesterol <130 mg/dL with tirzepatide in people with obesity: A post hoc analysis from the SURMOUNT trials.

BACKGROUND

Modest body weight reduction can greatly improve many health-related outcomes. In the SURMOUNT clinical trial program, once-weekly tirzepatide resulted in substantial body weight reductions in people with obesity, without and with type 2 diabetes.

OBJECTIVE

This post-hoc analysis assessed the proportion of participants achieving body weight reduction thresholds (≥5%, ≥10%, ≥15%), systolic blood pressure reduction ≥5 mmHg, and non-high-density lipoprotein cholesterol (non-HDL-C) <130 mg/dL with tirzepatide.

METHODS

Participants from SURMOUNT 1-4 randomized to tirzepatide or placebo with valid baseline and ≥1 non-missing post-baseline body weight, systolic blood pressure and non-HDL-C measurements were included in this analysis. The proportion of participants achieving the triple endpoints was assessed at the primary endpoint of each study (Week 72 for SURMOUNT-1, SURMOUNT-2 and SURMOUNT-3 and Week 88 for SURMOUNT-4).

RESULTS

Across the trials, 32-38% vs 2-8% of tirzepatide-treated vs placebo-treated participants achieved ≥5% body weight reduction, systolic blood pressure reduction ≥5 mmHg, and non-HDL-C <130 mg/dL, 28-37% vs 1-5%, respectively, achieved the triple endpoint with the ≥10% body weight reduction threshold, and 22-34% vs 1-3%, respectively, achieved the triple endpoint with the ≥15% body weight reduction threshold. The between-treatment odds ratios for these proportions across the trials, were statistically significant (all p<0.001).

CONCLUSION

In this post hoc analysis of SURMOUNT, more participants achieved the triple endpoint of body weight reduction thresholds, systolic blood pressure reduction ≥5 mmHg and non-HDL-C <130 mg/dL with tirzepatide vs placebo. Studies evaluating the potential cardiovascular benefits of tirzepatide are ongoing.

Copyright: © 2026 Sattar et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.