A Trial Within Cohort Feasibility Study Design Comparing Standard of Care Versus Weight Loss (Achieved Through Tirzepatide) for Obesity-related Hypertension in Young Adults

Exclusion Criteria

• •Anything in medical notes suggesting unsuitable in the opinion of the investigator
• •Eligibility criteria for participation in weight loss arm
• •The presence of any of the following will preclude participant inclusion:
• •Known or suspected secondary hypertension
• •Hypersensitivity to any of the study drugs or excipients
• •Currently taking drugs likely to have interactions with tirzepatide
• •Diagnosis of type 1 or type 2 diabetes mellitus or current usage of insulin or other injectable drugs for the treatment of diabetes such as but not limited to GLP-1 and GIP receptor agonists
• •Prior or planned surgical, endoscopic and/or device-based therapy treatment for obesity
• •Self-reported, intentional or unintentional, change in body weight (over \~10%) within \~three months of screening
• •Known heart failure or clinically significant valvular heart disease
• •Implanted pacemaker or implantable cardioverter defibrillator (ICD)
• •Second or third-degree AV block, sino-atrial block, sick sinus syndrome
• •Known active malignancy including thyroid cancer
• •Known renal impairment (creatinine \>150µmol/L)
• •Clinically significant neurological disease
• •History of scleroderma
• •Participants on anticoagulant therapy
• •Known history of pancreatitis
• •Known inflammatory bowel disease
• •History of gallstones (unless previous cholecystectomy)
• •Severe gastroparesis or gastric emptying abnormality
• •Family history of multiple endocrine neoplasia
• •Needle-phobia
• •Planned pregnancy, current pregnancy, or breastfeeding
• •Current involvement in the active treatment phase of other research studies
• •Any other clinical reason which may preclude entry in the opinion of the investigator