Pulse Wave Velocity and Sarcopenia in Older Persons—A Systematic Review and Meta-Analysis

Abstract

Sarcopenia and cardiovascular disease share some of the pathophysiologic mechanisms. Sarcopenia is likewise an important feature of frailty and the one potentially related to cardiovascular pathology. Previously, the relationship between arterial stiffness and frailty has been established. In this study, we conducted a systematic review and a meta-analysis of studies where the relationship between pulse wave velocity (PWV) and sarcopenia has been addressed. We included six cross-sectional studies that enrolled 5476 participants. Using the WebPlotDigitizer, RevMan5, and SAS 9.4, we extracted or calculated the summary statistics. We then calculated standardized mean differences (SMD) of PWV in the sarcopenic and non-sarcopenic participants. The pooled SMD was 0.73 (95% CI 0.39–1.08, p < 0.0001, I2 = 90%) indicating higher value in the sarcopenic subjects. The three studies that presented odds ratios for sarcopenia as a function of PWV homogenously indicated a greater probability of concomitant sarcopenia with higher values of PWV. Greater stiffness of the aorta is associated with sarcopenia. It is impossible to establish the causation. However, the plausible explanation is that increased stiffness may translate into or be an intermediary phenotype of common vascular and muscle damage. On the other hand, sarcopenia, which shares some of the inflammatory mechanisms with cardiovascular disease, may wind up the age-related large arterial remodeling.

The Effects of Obesity on the Inflammatory, Cardiovascular, and Neurobiological Responses to Exercise in Older Adults

“…Endothelial dysfunction is also associated with sarcopenia, the age-related loss in muscle mass, strength and/or function, where there is less nutritive blood flow to skeletal muscles from reduced capillarization [ 72 ]. Sarcopenia is highly related to the development of hypertension [ 73 ], arterial stiffness [ 74 , 75 ], endothelial dysfunction [ 76 ], and CVD via physical inactivity and inflammation [ 77 , 78 ]. Sarcopenic obesity is more catastrophic than sarcopenia and obesity alone [ 79 ] and is becoming increasingly prevalent in the sedentary aging population, where there is a large imbalance of adipose-to-muscle tissue ratio and is associated with disability, CVD and mortality [ 80 , 81 ].…”

Combined L-Citrulline Supplementation and Slow Velocity Low-Intensity Resistance Training Improves Leg Endothelial Function, Lean Mass, and Strength in Hypertensive Postmenopausal Women

“…Low availability of L-arginine (ARG), the substrate for NO synthesis, contributes to endothelial dysfunction in postmenopausal women [ 4 ]. Growing evidence suggests that endothelial dysfunction and high arterial stiffness are associated with decreased limb lean mass (LM) and strength in older adults, particularly in women [ 5 , 6 , 7 , 8 ]. The impact of arterial stiffening is evident on the thigh muscles of older women [ 9 ].…”

“…The impact of arterial stiffening is evident on the thigh muscles of older women [ 9 ]. In fact, evidence suggests that age-related limb vascular dysfunction may impair muscle blood flow and contribute to declines in muscle mass and strength [ 8 , 10 ]. Inverse associations between vascular dysfunction and skeletal muscle abnormalities are observed in hypertensives [ 10 ].…”

Additive damage in the thromboxane related vasoconstriction and bradykinin relaxation of intramural coronary resistance arterioles in a rodent model of andropausal hypertension

“…Furthermore, triglyceride/high-density lipoprotein ratio might be used for prediction to early vascular aging [ 30 ]. There is a reciprocal relationship between sarcopenia and vascular aging: advanced vascular aging leads to a decrease in skeletal muscle mass, while sarcopenia (loss of muscle mass and strength) increases cardiovascular burden [ 31 ].…”