Northwestern Medicine scientists announced on June 14 that GLP-1 drugs are associated with a higher risk of dizziness, fainting, and other events related to low blood pressure among adults already taking at least two types of blood pressure medications. The research team analyzed health record data from more than 42,000 adults who began GLP-1 therapy while on antihypertensive medications.
The study found that hypotensive episodes were most common among patients aged 65 and older and those with diabetes. These findings will be presented at ENDO 2026, the Endocrine Society's annual meeting.
Study senior author Dr. Micah Eimer said, "I'm a big proponent of GLP-1s, they are huge." However, Eimer added, "I'm just saying, let's watch out for hypotensive events in select patients because I think there's the potential to do harm." He also said he is particularly concerned about patients obtaining GLP-1s without direct clinical supervision.
Eimer's team tracked hypotensive events over six, twelve, and twenty-four months after starting GLP-1 therapy. Events included dizziness, fainting, falls, low blood pressure diagnoses, systolic readings below 90 mm Hg, and prescriptions for medications used to treat hypotension. The study observed a statistically significant 1.5% increase in hypotensive events within six months after initiating GLP-1s.
"It is statistically significant, and the consequences of hypotension can be terrible," Eimer said. "People die from that. You can hit your head or you can crash your car or break your hip." He emphasized that clinicians should monitor at-risk patients closely: "All we're proposing to clinicians is 'Hey, think about the patients who are at risk and have a strategy to monitor and mitigate that risk.'"
Regarding why older adults and people with diabetes may be more susceptible after starting these drugs, Eimer said: "Older patients are just more susceptible to changes in blood pressure...patients with diabetes may have autonomic dysfunction...Finally there are mechanisms of action of these GLP-1s that we don't completely understand."
