What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Hypertension (n=4846). Intervention: Obese sarcopenia vs. Non-obese non-sarcopenia. Primary outcome: Hypertension (OR 3.0, 95% CI 2.48-3.63, p=<0.001).

January 29, 2014PLoS ONE163 citationsOpen Access

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

Q: What are the key findings of this study?

Obese sarcopenia was associated with a significantly higher risk of hypertension compared to non-obese non-sarcopenia (OR 3.0) in older Korean adults.

KHKyungdo Han YPYu‐Mi Park YPYu‐Mi Park

Key Result

Obese sarcopenia was associated with a significantly higher risk of hypertension compared to non-obese non-sarcopenia (OR 3.0) in older Korean adults.

Study Design

Type

Cross-Sectional (n=4,846)

PICO

Population

4,846 Korean adults aged 60 years or older from a national health survey, evaluated for the association between sarcopenic obesity and hypertension.

Exposure / Comparator

Obese sarcopenia vs Non-obese non-sarcopenia

Primary Outcome

Hypertension — OR 3.0 (2.48-3.63), p=<0.001

Main Result

Odds Ratio: 3 (95% CI 2.48–3.63)

Absolute Event Rate: 74.7% vs 49.7%

p-value: p=<0.001

Limitations

Cross-sectional design limits the ability to detect causal relationships.
Findings cannot be extrapolated to other racial groups.
Hypertension was defined based on blood pressure measurement on only one occasion, which may introduce white-coat effect and random variability.
Preference for zero end-digit in the BP measurement may indicate low-quality measurement.

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-obese sarcopenia, 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 sarcopenia group, 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.

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