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Reassessing Sarcopenia In Hypertension: STAR and ACE Inhibitors Excel
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  • Ayşe Merve Ata,
  • Murat Kara,
  • Timur Ekiz,
  • Ozgur Kara,
  • Mehmet Ali Culha,
  • Vincenzo Ricci,
  • Esra Gizem Koyuncu,
  • Fırat Özcan,
  • Bayram Kaymak,
  • Levent Özçakar
Ayşe Merve Ata
Bursa Doctor Ayten Bozkaya Spastic Children Hospital and Rehabilitation Center
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Murat Kara
Hacettepe Universitesi
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Timur Ekiz
Türkmenbaşı Medical Center
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Ozgur Kara
Yildirim Beyazit Universitesi
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Mehmet Ali Culha
Hacettepe Universitesi
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Vincenzo Ricci
IRCCS Istituto Ortopedico Rizzoli
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Esra Gizem Koyuncu
Hacettepe Universitesi
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Fırat Özcan
Ministry of Health Ankara City Hospital
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Bayram Kaymak
Hacettepe Universitesi
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Levent Özçakar
Hacettepe Universitesi
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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 233 community dwelling adults were recruited. Anterior thigh muscle thickness was measured by ultrasound. Handgrip strength, gait speed and chair stand test were evaluated. Presarcopenia 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: 109 subjects (46.8%) had no comorbid disease; 93 (75.0%) had one, 21 (16.9%) had two, eight (6.5%) had three and two (1.6%) had four comorbid diseases. Both presarcopenia (48.3% vs. 21.1%) and sarcopenia (33.3% vs. 7.0%) were more commonly seen in hypertensive when compared to normotensive older adults. Subgroup analysis of older adults with hypertension revealed that sarcopenia was less prevalent (p=0.020) in patients using ACE inhibitors (9.1%) than those using angiotensin receptor blockers (ARBs) (40.5%) and other antihypertensive drugs (42.9%). After binary logistic regression analyses; only the presence of hypertension seemed to independently predict the development of sarcopenia in older adults [OR=7.9 (95% CI: 2.6-24.5, p<0.001)]. Conclusions: Sarcopenia is highly prevalent in hypertensive older adults. Among many antihypertensive medications, ACE inhibitors seem to have favorable effects on both disorders.

Peer review status:Published

10 May 2020Submitted to International Journal of Clinical Practice
13 May 2020Submission Checks Completed
13 May 2020Assigned to Editor
08 Oct 2020Reviewer(s) Assigned
16 Oct 2020Review(s) Completed, Editorial Evaluation Pending
19 Oct 20201st Revision Received
22 Oct 2020Submission Checks Completed
22 Oct 2020Assigned to Editor
22 Oct 2020Reviewer(s) Assigned
23 Oct 2020Review(s) Completed, Editorial Evaluation Pending
23 Oct 2020Editorial Decision: Accept
27 Oct 2020Published in International Journal of Clinical Practice. 10.1111/ijcp.13800