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This is the most clinically significant concern, as sustained heart rate elevation can increase cardiovascular risk in predisposed individuals Elevated blood pressure modest increases in both systolic and diastolic blood pressure were noted Restlessness and anxiety related to increased norepinephrine and dopamine activity Constipation reported by approximately 1520% of participants Nausea less common than with GLP-1 medications, reported by approximately 10% The cardiovascular effects elevated heart rate and blood pressure are the primary safety concerns with tesofensine