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