Reassessing Sarcopenia in Hypertension: STAR and ACE Inhibitors Excel

• Published in: International journal of clinical practice (Esher) Vol. 75; no. 3; pp. e13800 - n/a
• Main Authors: Ata, Ayşe Merve, Kara, Murat, Ekiz, Timur, Kara, Özgür, Culha, Mehmet Ali, Ricci, Vincenzo, Koyuncu, Esra Gizem, Özcan, Fırat, Kaymak, Bayram, Özçakar, Levent
• Format: Journal Article
• Language: English
• Published: England John Wiley & Sons, Inc 01.03.2021
• Subjects: Aged; Angiotensin II; Angiotensin-converting enzyme inhibitors; Angiotensin-Converting Enzyme Inhibitors - adverse effects; Antihypertensives; Comorbidity; Diuretics; Gait; Hand Strength; Humans; Hypertension; Hypertension - drug therapy; Hypertension - epidemiology; Older people; Renin; Sarcopenia; Sarcopenia - epidemiology; Thigh; Ultrasound
• ISSN: 1368-5031; 1742-1241; 1742-1241
• DOI: 10.1111/ijcp.13800

Background Hypertension and sarcopenia are commonly seen in older adults. The renin‐angiotensin system and the therapeutic use of angiotensin‐converting enzyme (ACE) inhibitors have been on the agenda of sarcopenia in different perspectives. Our aim was to explore the frequency of sarcopenia in patients with hypertension and to investigate the association between the use of ACE inhibitors and sarcopenia. Methods A total of 272 community‐dwelling adults were recruited. Anterior thigh muscle thickness was measured by ultrasound. Handgrip strength, gait speed, and chair stand test were evaluated. Low muscle mass was diagnosed in the presence of low sonographic thigh adjustment ratio (STAR) values and sarcopenia was diagnosed if low STAR values were coupled with low functional tests. Results 136 subjects (50.0%) had no comorbid disease; 102 (37.5%) had one, 21 (7.7%) had two, nine (3.3%) had three and four (1.5%) had four comorbid diseases. Both low muscle mass (41.9% vs 13.2%) and sarcopenia (32.2% vs 7.8%) were more commonly seen in hypertensive when compared with normotensive older adults. Subgroup analysis of older adults with hypertension revealed that sarcopenia was less prevalent (P = .003) in patients using ACE inhibitors (8.7%) than those using angiotensin II receptor blockers (48.7%) and other antihypertensive drugs (46.4%). After binary logistic regression analyses; only the presence of hypertension seemed to independently predict the development of sarcopenia in older adults [OR = 6.5 (95% CI: 2.4‐17.8, P < .001)]. Conclusions Sarcopenia is highly prevalent in hypertensive older adults. Amongst many antihypertensive medications, ACE inhibitors seem to have favourable effects on both disorders.