Well managed taper. A few things I want to highlight for anyone in a similar situation:

1. DO NOT stop blood pressure medications on your own. This was done under cardiologist supervision with a gradual taper and close monitoring. Abruptly stopping antihypertensives can cause rebound hypertension which is dangerous.
2. The relationship between weight and blood pressure is well-established: roughly 1 mmHg systolic drop per 1 kg (2.2 lbs) lost. The OP lost 49 lbs, which predicts about a 22 mmHg systolic drop — and they got a 28 point drop (148→120), suggesting the semaglutide may have additional direct vascular benefits beyond weight loss.
3. Home monitoring the way you're doing it — morning, fasted, averaged, multiple readings — is actually considered more reliable than office readings for diagnosing and managing hypertension.

Given your family history, I'd recommend asking about a coronary calcium score if you haven't had one. It's a cheap CT scan that directly quantifies arterial plaque.

Congrats. Getting off a medication you've been on for 6 years must feel incredible.

I had a similar experience — was on amlodipine 10mg for 4 years, now off it after 7 months on semaglutide. BP is consistently 118-122/72-76. My doctor said the weight loss essentially "cured" the hypertension, though he prefers the term "resolved" since it could come back if weight is regained.

That's exactly the word my cardiologist used — "resolved." He was very clear that if I stop semaglutide and regain weight, the hypertension will very likely return. He also said that the longer I maintain a healthy weight and normal BP, the less likely that is, because the vascular remodeling that happens with chronic hypertension can partially reverse over time.

And yes, I've had a CAC scan — scored 42, which is moderate for my age. Another reason I'm staying on top of cardiovascular health.

This gives me hope. I'm on lisinopril 10mg + hydrochlorothiazide 12.5mg. 4 months into semaglutide, BP is already trending down. Going to discuss with my doc at my next visit about whether we can start reducing.