Sarcopenia as a Determinant of Blood Pressure in Older Koreans

PLoS One. 2014 Jan 29;9(1):e86902. doi: 10.1371/journal.pone.0086902. eCollection 2014.

Sarcopenia as a Determinant of Blood Pressure in Older Koreans: Findings from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008-2010.

Han K1, Park YM2, Kwon HS3, Ko SH3, Lee SH3, Yim HW4, Lee WC4, Park YG5, Kim MK3, Park YM6.

Author information

• 1Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea ; Department of Biostatistics, The Catholic University of Korea, Seoul, Korea.
• 2School of Medicine, The Catholic University of Korea, Seoul, Korea.
• 3Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
• 4Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea.
• 5Department of Biostatistics, The Catholic University of Korea, Seoul, Korea.
• 6Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea ; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.

Abstract

BACKGROUND:

Blood pressure (BP) is directly and causally associated with body size in the general population. Whether muscle mass is an important factor that determines BP remains unclear.

OBJECTIVE:

To investigate whether sarcopenia is associated with hypertension in older Koreans.
PARTICIPANTS:

We surveyed 2,099 males and 2,747 females aged 60 years or older.

MEASUREMENTS:

Sarcopenia was defined as an appendicular skeletal muscle mass divided by body weight (ASM/Wt) that was <1 SD below the gender-specific mean for young adults. Obesity was defined as a body mass index (BMI) ≥25 kg/m(2). Subjects were divided into four groups based on presence or absence of obesity or sarcopenia. Hypertension was defined as a systolic BP (SBP) ≥140 mmHg, a diastolic BP (DBP) ≥90 mmHg, or a self-reported current use of antihypertensive medications.

RESULTS:

The overall prevalence of hypertension in the four groups was as follows 49.7% for non-obese non-sarcopenia, 60.9% for non-obesesarcopenia, 66.2% for obese non-sarcopenia and 74.7% for obese sarcopenia. After adjustment for age, gender, regular activity, current smoking and alcohol use, the odds ratio (OR) for having hypertension was 1.5 (95% confidence interval (CI) = 1.23-1.84) in subjects in the non-obese sarcopeniagroup, 2.08 (95% CI = 1.68-2.57) in the obese non-sarcopenia group and 3.0 (95% CI = 2.48-3.63) in the obese sarcopenia group, compared with the non-obese non-sarcopenia group (p for trend <0.001). Controlling further for body weight and waist circumference did not change the association between hypertension and sarcopenia. The association between sarcopenia and hypertension was more robust in the subjects with diabetes mellitus.

CONCLUSION:

Body composition beyond BMI has a considerable impact on hypertension in elderly Koreans. Subjects with sarcopenic obesity appear to have a greater risk of hypertension than simply obese or sarcopenia subjects.