Association Between Glucagon-Like Peptide-1 (GLP-1) Receptor Agonist Use and Blood Pressure Levels in Nondiabetic Obese Adults: A Cross-Sectional Analysis

Background and aim Obesity is strongly linked to elevated blood pressure and increased cardiovascular risk. Glucagon-like peptide-1 (GLP-1) receptor agonists have gained attention for their role in weight management and potential cardiovascular benefits. Evidence in nondiabetic populations remains limited. The aim of this study was to descriptively evaluate the association between GLP-1 receptor agonist use and systolic and diastolic blood pressure levels among nondiabetic adults with obesity. Methods This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2017 to March 2020 prepandemic cycle, selected to ensure use of the most recent complete data prior to disruptions related to the COVID-19 pandemic. Adults aged 18 years or older with obesity were included, and individuals with self-reported diabetes were excluded. GLP-1 receptor agonist use was identified from prescription medication data, with a very small number of exposed participants in the analytic sample. Blood pressure was assessed using standardized examination measures. A complete-case approach was applied, whereby participants with missing data on any variables included in the analysis were excluded to ensure a consistent analytic sample. Analyses incorporated NHANES examination sample weights to produce nationally representative estimates and accounted for the complex survey design by including stratification and primary sampling units to ensure correct variance estimation. Descriptive statistics were used to compare characteristics by exposure. Results Lower systolic blood pressure was observed among GLP-1 users compared with nonusers (107.2 vs 122.1 mmHg), and diastolic blood pressure was also lower (74.4 vs 76.9 mmHg). The proportion of hypertension was lower among GLP-1 users, 5,814 (14.1%), compared with nonusers, 25,207,405 (36.5%). The extremely small number of exposed participants (n = 2) limited further statistical analysis and inference. Conclusions Lower blood pressure levels were observed among GLP-1 receptor agonist users compared with nonusers in this population. These findings are descriptive and reflect observed differences in blood pressure within the analytic sample, without implying a causal relationship. Further studies using datasets with greater representation of GLP-1 receptor agonist use in nondiabetic populations are needed to better characterize this relationship.