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SARcopenia Assessment in Hypertension: The SARAH Study
Murat Kara1, Özgür Kara, Yasin Ceran
1From the Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (MK, BK, EGK, PA, HO, LÖ); Department of Internal Medicine, Dr Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey (ÖK, TCK, BNÇ, MED, ED, GT); Department of Business and Technology Management, Korea Advanced Institute of Science and Technology, Seoul, South Korea (YC); Combined Military Hospital & Quetta Institute of Medical Sciences, Quetta, Pakistan (SR); Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey (YD); Physical Medicine and Rehabilitation Hospital, Andalous, Kuwait (DS, AJA); Department of Physical Medicine and Rehabilitation, Physical Medicine and Rehabilitation Hospital, Andalous, Kuwait (SAA); Department of Physical Medicine and Rehabilitation, Ankara City Hospital, Ankara, Turkey (AMA, FÜM); Department of Physical Medicine and Rehabilitation, University of Health Science, Basaksehir Cam and Sakura City Hospital, İstanbul, Turkey (EC); Department of Physical and Rehabilitation Medicine, Dokuz Eylül University Medical School, İzmir, Turkey (B. Dilek); Department of Physical and Rehabilitation Medicine, Kozan State Hospital, Adana, Turkey (MAC); Department of Physical Medicine and Rehabilitation, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey (PY); Charles University and General University Hospital, Prague, Czech Republic (KM); Department of Physical Medicine and Rehabilitation, University of Health Sciences, Sisli Hamidiye Etfal Teaching and Research Hospital, Istanbul, Turkey (B. Doğu); Department of Physical and Rehabilitation Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey (GK); Department of Physical Medicine and Rehabilitation, Celal Bayar University, Manisa, Turkey (ZÜ); Department of Physical Medicine and Rehabilitation, Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal (JB, SP); Department of Physical Medicine and Rehabilitation, İstanbul University-Cerrahpaşa Cerrahpaşa School of Medicine, İstanbul, Turkey (DP); Department of Physical Medicine and Rehabilitation, Mersin University Faculty of Medicine, Mersin, Turkey (OG); Department of Neurology, Stanford University, Stanford, California (MB); and Division of Epidemiology, Department of Public Health, Hacettepe University Medical School, Ankara, Turkey (BÇ).
Objectives:
The aims of the study were to investigate the relationship between sarcopenia and renin-angiotensin system-related disorders and to explore the effects of angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers on muscle mass/function and physical performance.
Design:
This multicenter, cross-sectional study was performed using ISarcoPRM algorithm for the diagnosis of sarcopenia.
Results:
Of the 2613 participants (mean age = 61.0 ± 9.5 yrs), 1775 (67.9%) were hypertensive. All sarcopenia-related parameters (except chair stand test in males) were worse in hypertensive group than in normotensive group (all P < 0.05). When clinical/potential confounders were adjusted, hypertension was found to be an independent predictor of sarcopenia in males (odds ratio = 2.403 [95% confidence interval = 1.514-3.813]) and females (odds ratio = 1.906 [95% confidence interval = 1.328-2.734], both P < 0.001). After adjusting for confounding factors, we found that all sarcopenia-related parameters (except grip strength and chair stand test in males) were independently/negatively related to hypertension (all P < 0.05). In females, angiotensin-converting enzyme inhibitors users had higher grip strength and chair stand test performance values but had lower anterior thigh muscle thickness and gait speed values, as compared with those using angiotensin II receptor blockers (all P < 0.05).
Conclusions:
Hypertension was associated with increased risk of sarcopenia at least 2 times. Among antihypertensives, while angiotensin-converting enzyme inhibitors had higher muscle function values, angiotensin II receptor blockers had higher muscle mass and physical performance values only in females.
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