Lean Body Mass Associates With a Hypertensive Cardiovascular Phenotype in Men but Not in Women

Lean body mass (LBM) is independently associated with the function and structure of the cardiovascular (CV) system in women and genetically predisposed men with low LBM. Yet, the relationship between LBM and the CV system remains uncertain in the general population comprising a wide spectrum of LBM.

A total of 325 healthy women (n = 162) and men (n = 163) throughout the adult lifespan (18-78 years) matched by age (age = 43 ± 18 vs. 44 ± 18 years) and physical activity were included. Body composition, including LBM, fat and bone mass, was assessed in total and per body region (legs, arms and trunk) by dual-energy x-ray absorptiometry. Left ventricular (LV) mass and structure as well as peripheral and central haemodynamics were determined via echocardiography and continuous blood pressure measurements.

Women presented with lower total LBM (p < 0.001) and higher body fat (p < 0.001) than men. Total LBM did not associate with systolic blood pressure (SBP) in women (p = 256) but did positively associate with SBP in men (r = 0.31, p < 0.001). Total LBM did not associate with LV concentric hypertrophy (LVRWTd) in women (p = 448) but did positively associate with LVRWTd in men (r = 0.24, p = 0.003). Similar sex-specific associations were observed for regional LBM, except for arm LBM, which associated with all study variables in women. Adjustment by body fat or body fat percentage did not modify the results.

Total LBM independently associates with a hypertensive CV phenotype in men, whereas regional LBM, specifically in the arms, is linked with the same detrimental phenotype in women.