Association between pulse pressure and low muscle mass in Korean adults: A nationwide cross-sectional study

Abstract

Sarcopenia is characterized by a loss of muscle mass and strength and is associated with a high risk of cardiovascular events and increased mortality. Pulse pressure (PP) serves as a marker for changes in heart structure and function, as well as arterial stiffness. A high PP also increases the risk of cardiovascular disease and all-cause mortality. However, the relationship between PP and sarcopenia is poorly understood. We used the data of participants of the Korea National Health and Nutrition Examination Survey (KNHANES) of 2008 to 2011. Participants were divided into a control group (PP < 40 mm Hg) and a high-PP group (PP ≥ 40 mm Hg). PP was calculated by subtracting the diastolic blood pressure (DBP) from the systolic blood pressure (SBP), and the low muscle index was assessed using appendicular skeletal muscle mass (ASM) normalized by body mass index (BMI). Multiple logistic regression analyses were performed to examine the association between PP and the prevalence of low muscle mass, adjusting for potential confounders. The high-PP group had a higher age, SBP, DBP, and prevalence of hypertension, diabetes and hyperlipidemia than the control group. The high-PP group had a higher prevalence of low muscle mass than the control group in all models. A high PP is significantly associated with a higher prevalence of low muscle mass. Therefore, PP monitoring may help identify individuals at risk of sarcopenia and guide interventions to improve health outcomes.

Relationship between Pulse Pressure and Handgrip Strength in the Korean Population: A Nationwide Cross-Sectional Study

“…Several possible pathways have been considered, although the precise processes related to PP and sarcopenia are poorly understood. First, because high PP indicates hard arterial stiffness and low arterial compliance, this may result in endothelial dysfunction by reducing microcirculation, which may lead to muscle fiber atrophy and sarcopenia [ 40 , 41 ]. Second, arterial stiffness, which is closely related to oxidative stress and chronic molecular inflammation, plays an important role in muscle inflammation and loss [ 40 , 41 ].…”

“…First, because high PP indicates hard arterial stiffness and low arterial compliance, this may result in endothelial dysfunction by reducing microcirculation, which may lead to muscle fiber atrophy and sarcopenia [ 40 , 41 ]. Second, arterial stiffness, which is closely related to oxidative stress and chronic molecular inflammation, plays an important role in muscle inflammation and loss [ 40 , 41 ]. The presence of inflammatory factors and reactive oxygen species is associated with a potential inhibition of protein synthesis and an increase in protein degradation, potentially contributing to the development of sarcopenia [ 40 ].…”