INTRODUCTION
By and large, the population is getting older; and physicians
unavoidably/undoubtedly become exposed to problems of older adults in
daily practice. Hypertension and sarcopenia appear to be such/two
commonplace problems in this sense. The former is one of the most
prevalent disorders that cause cardiovascular disease and mortality, and
its prevalence (overall about 45%) reaches >60% in
>60 years old adults.1,2 The latter -
age-related loss of muscle mass and function - is also a global public
health problem in older adults i.e. with a prevalence of 10% in ≥60
years old.3
In recent years, a possible ‘cross-talk’ between the two aforementioned
disorders has increasingly been reported. Particularly, the
renin-angiotensin system (RAS) and the therapeutic use of angiotensin
converting enzyme (ACE) inhibitors have been the main concerns for
exploring whether sarcopenia is more prevalent in hypertensive
individuals and/or various antihypertensives might impact sarcopenia in
different ways. Herein, the RAS is a major regulator of blood pressure
and it also regulates muscle mass.4 As such, the
presence of an active classical RAS axis exerts deleterious effects not
only on the cardiovascular system but also on the skeletal muscles. Yet,
increased levels of angiotensin II (Ang-II) are known to cause several
conditions like insulin resistance, atrophy and fibrosis of
muscles.4
On the other hand; either due to the use of different techniques to
define sarcopenia or the complexity of hypertension treatment, the
pertinent literature is quite heterogenous as well as inconclusive.
Accordingly, the purpose of this study was two-fold; first we tried to
explore the frequency of sarcopenia in patients with hypertension, and
second, we aimed to investigate the association between the use of ACE
inhibitors and sarcopenia. In this regard, we have used a novel/robust
approach to detect early/regional muscle loss i.e. anterior thigh muscle
mass measurements for prompt diagnosis of sarcopenia.5