Lower muscle tissue is associated with higher pulse wave velocity: A systematic review and meta‐analysis of observational study data

Abstract

Muscle loss and arterial stiffness share common risk factors and are commonly seen in the elderly. We aimed to synthesise the existing literature on studies that have examined this association. We searched electronic databases for studies reporting correlations or associations between a measure of muscle tissue and a measure of arterial stiffness. Meta-analysis was conducted using Fisher's Z-transformed r-correlation (r ) values. Pooled weighted r and 95% confidence intervals were calculated in an inverse-variance, random-effects model. Heterogeneity was assessed by the inconsistency index (I ). Study quality was assessed on a checklist using items from validated quality appraisal guidelines. 1195 records identified, 21 satisfied our inclusion criteria totalling 8558 participants with mean age 52±4 years (range 23-74). Most studies reported an inverse relationship between muscle tissue and arterial stiffness. Eight studies had data eligible for meta-analysis. Muscle tissue was inversely associated with pulse wave velocity in healthy individuals [r =-.15 (95% CI -0.24, -0.07); P=.0006; I =85%; n=3577] and in any population [r =-.18 (-0.26, -0.10); P<.0001; I =81%; n=3930]. In a leave-one-out sensitivity analysis, the results remained unchanged. Lower muscle tissue was associated with arterial stiffness. Studies were limited by cross-sectional design. Cardiovascular risk monitoring may be strengthened by screening for low muscle mass and maintaining muscle mass may be a primary prevention strategy.

Exploring the Association between Vascular Dysfunction and Skeletal Muscle Mass, Strength and Function in Healthy Adults: A Systematic Review

“…Although the focus of this systematic review has been on relatively healthy subjects, the association between skeletal muscle health and vascular dysfunction has been demonstrated in other populations. A recent meta-analysis examined macrovascular function through pulse wave velocity and demonstrated that lower muscle tissue is associated with higher arterial stiffness in populations with diabetes and kidney disease [21]. This association has been demonstrated in healthy children as well, in which researchers determined that arterial stiffness (measured by CIMT) is negatively associated with muscular strength [79].…”

“…Given that many of the risk factors for sarcopenia and cardiovascular disease are shared, it is not surprising that there is an association between measures of vascular dysfunction and muscle health. Existing reviews solely target arterial stiffness as an indicator of vascular dysfunction and its' association with skeletal muscle health [21]. This systematic review takes a broader approach and examines other validated indices of vascular function including microvascular function.…”

“…Such blunted blood flow responses may contribute to age-related declines in anabolic responses to feeding by reducing the delivery and/or utility of insulin and amino acids (AA) in muscle [19,20]. In addition, more recently, Rodriguez and colleagues examined pulse wave velocity as an indicator of arterial stiffness in a meta-analysis and demonstrated that lower muscle mass is significantly associated with increased arterial stiffness [21].…”

“…While the included studies demonstrate various relationships between skeletal muscle health and vascular health, it remains unclear as to whether there is a causal relationship between the two. Given that there are some shared risk factors for declines in both systems, the relationship between them should be explored in a systematic way [21]. One previous systematic review attempted to do this but focused specifically on arterial stiffness assessed through PWV and did not explore other indices of macro or microvascular status [21].…”

“…Given that there are some shared risk factors for declines in both systems, the relationship between them should be explored in a systematic way [21]. One previous systematic review attempted to do this but focused specifically on arterial stiffness assessed through PWV and did not explore other indices of macro or microvascular status [21]. Therefore, the aim of this systematic review is to determine if there is a relationship between skeletal muscle health and both macro-and microvascular function.…”