Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea National Health and Nutrition Examination Surveys (KNHANES) 2008-2010.
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.


METHODS
We surveyed 2,099 males and 2,747 females aged 60 years or older.


METHODS
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.


CONCLUSIONS
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.
Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea ; Department of Biostatistics, The Catholic University of Korea, Seoul, Korea.
Kyungdo
K
Han
School of Medicine, The Catholic University of Korea, Seoul, Korea.
Yu-Mi
YM
Park
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Hyuk-Sang
HS
Kwon
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Seung-Hyun
SH
Ko
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Seung-Hwan
SH
Lee
Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea.
Hyeon Woo
HW
Yim
Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea.
Won-Chul
WC
Lee
Department of Biostatistics, The Catholic University of Korea, Seoul, Korea.
Yong Gyu
YG
Park
Division of Endocrinology and Metabolism, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea.
Mee Kyoung
MK
Kim
Department of Preventive Medicine, The Catholic University of Korea, Seoul, Korea ; Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America.
Yong-Moon
YM
Park
D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D015992:Body Mass Index; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology; D009749:Nutrition Surveys; D009765:Obesity / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D009929:Organ Size; D056910:Republic of Korea / Q000453:epidemiology; D055948:Sarcopenia / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*