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Relationship between sarcopenia and orthostatic hypotension
Pinar Soysal1, Suleyman Emre Kocyigit2, Ozge Dokuzlar2
1Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.
Insights
Older adults with severe sarcopenia have a higher risk of orthostatic hypotension (OH). Healthcare providers should assess for OH in patients with sarcopenia and vice versa.
Area of Science:
- Geriatrics
- Cardiovascular Medicine
- Aging Research
Background:
- The link between sarcopenia and orthostatic hypotension (OH) in older adults is not well-established.
- Sarcopenia, characterized by loss of muscle mass and strength, is common in aging populations.
- Orthostatic hypotension, a drop in blood pressure upon standing, poses risks like falls and syncope.
Purpose of the Study:
- To investigate the association between sarcopenia, its severity, and the presence of orthostatic hypotension.
- To determine if individuals with sarcopenia are more likely to experience OH.
Main Methods:
- A cohort of 511 geriatric outpatient clinic patients was analyzed.
- Orthostatic hypotension was diagnosed using the Head-up Tilt Table test (measuring blood pressure changes upon standing).
- Sarcopenia and its severity were classified based on the revised European consensus criteria.
Main Results:
- The prevalence of probable sarcopenia, sarcopenia, and severe sarcopenia was 42.2%, 6.06%, and 11.1%, respectively.
- Severe sarcopenia was significantly associated with increased odds of systolic orthostatic hypotension at 1 and 5 minutes (OH1, OH5) and overall OH1.
- Systolic OH1 was also significantly different between sarcopenia and severe sarcopenia groups.
Conclusions:
- A significant relationship exists between sarcopenia, particularly severe sarcopenia, and orthostatic hypotension in older adults.
- Clinicians should consider screening for OH in elderly patients diagnosed with sarcopenia.
- Conversely, OH evaluation may be warranted in older adults presenting with sarcopenia.
Background:
The relationship between sarcopenia and orthostatic hypotension (OH) is unclear.
Objectives:
The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH.
Design:
A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis.
Results:
The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98-10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31-14.15; P = 0.016 for OH1; OR 4.09, CI 1.01-16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87-8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05).
Conclusions:
There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.
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