Sarcopenic obesity and arterial stiffness in adolescents with primary hypertension

Background Adolescent obesity and primary hypertension represent a high-risk cardiometabolic profile. Reduced muscle strength may further worsen this burden through the development of sarcopenic obesity (SO). Although handgrip strength is a practical indicator of muscular function in youth, the prevalence of SO and its relationship with vascular measures in obese hypertensive adolescents remain insufficiently defined. Purpose This study aimed to evaluate the presence of the SO phenotype and its relationship with arterial stiffness in obese adolescents with primary hypertension. Methods The study included 16 obese adolescent boys with hypertension. To find the gender-based cut-off value, the study included a control group of 15 boys. Sex-specific cut-off values below the 25th percentile of relative handgrip strength (RHGS) in controls were used to define SO. Obese hypertensive participants were categorised as SO or non-SO. Isometric handgrip strength was measured using a standard handheld dynamometer in a seated position, and the mean of three trials for each hand was recorded. Arterial stiffness parameters augmentation index (AIx@75) and pulse wave velocity (PWV) were assessed using a validated oscillometric device, with three consecutive measurements obtained from the non-dominant arm. Results There is no difference between the groups in terms of age and BMI (p=0.058 and p=0.333, respectively ). SO was identified in 50 % of obese hypertensive adolescents (8 of 16 boys). Dominant and non-dominant handgrip strengths were significantly lower in the SO group compared with the non-SO group (p<0.001 and p = 0.011, respectively). RHGS was also markedly reduced in the SO group (0.96 ± 0.16 vs. 1.58 ± 0.19; p < 0.001). No significant group differences were observed for AIx@75 (p = 0.120) or PWV (p = 0.594). Conclusion A substantial proportion of obese adolescents with primary hypertension exhibited the SO phenotype, characterised by markedly reduced absolute and relative handgrip strength. However, arterial stiffness parameters did not differ between SO and non-SO groups, suggesting that muscular impairment may emerge earlier than detectable vascular alterations in this population. This pattern may reflect the earlier onset of functional decline compared with macrovascular change in hypertensive obese adolescents.