Reassessing Sarcopenia in Hypertension: STAR and ACE Inhibitors Excel

Abstract

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.

Serum Sestrin-1 Concentration Is Higher in Frail than Non-Frail Older People Living in Nursing Homes

“…A similar controversy has also surrounded other molecules related to muscle function that have been proposed as biomarkers for frailty such as myostatin [47][48][49][50][51], follistatin [48,[50][51][52], and renin-angiotensin system elements [53][54][55][56][57]. Some authors have proposed that myostatin may act as a chalone, by turns restraining skeletal muscle growth in response to unfavorable metabolic scenarios or decreasing its own activity, when there is no need to restrain growth [50,51,[58][59][60].…”

“…Recently, Picca et al [68] have described a U-shaped association between mTOR and cognitive function along the aging process. Thus, it may be that the seemingly contradictory results regarding certain putative molecular biomarkers of frailty are due to the up-regulation of compensatory systems on the frail organism, resulting in a U-shaped association; that is, during aging process, the serum concentration of such molecules is affected in one sense (increasing or decreasing), but later, the organism's compensatory mechanisms provoke the opposite effects (decreasing or increasing, respectively) [47,48,[50][51][52][53][54][55][56][57]. This is merely a general hypothesis that must to be confirmed for each molecule proposed as a biomarker.…”

Dieckol Reduces Muscle Atrophy by Modulating Angiotensin Type II Type 1 Receptor and NADPH Oxidase in Spontaneously Hypertensive Rats

“…Sarcopenia is more frequently presented in hypertensive patients than in normotensive adults (32.2 vs. 7.8%) [2]. Additionally, hypertension independently increases the risk of sarcopenia more than 6.5 times more than normal blood pressure [2].…”

“…Sarcopenia is more frequently presented in hypertensive patients than in normotensive adults (32.2 vs. 7.8%) [2]. Additionally, hypertension independently increases the risk of sarcopenia more than 6.5 times more than normal blood pressure [2]. Many studies have shown that RAS is possibly the main commonality between the pathophysiology of sarcopenia and hypertension.…”

“…The renin-angiotensin system (RAS) is an essential and dominant regulatory pathway of blood pressure [1]. It is also involved in muscle atrophy or sarcopenia [2].…”