Relationship between sarcopenia and orthostatic blood pressure recovery in older falls clinic attendees

Abstract

Purpose Sarcopenia and delayed orthostatic blood pressure (BP) recovery are two disorders increasingly associated with adverse clinical outcomes in older adults. There may exist a pathophysiological link between the two via the skeletal muscle pump of the lower limbs. Previously in a large population-based study, we found an association between probable sarcopenia and orthostatic BP recovery. Here, we sought to determine the association between confirmed sarcopenia and orthostatic BP recovery in falls clinic attendees aged 50 years or over. Methods One hundred and nine recruited patients (mean age 70 years, 58% women) underwent an active stand with non-invasive beat-to-beat haemodynamic monitoring. Hand grip strength and five-chair stands time were measured, and bioelectrical impedance analysis was performed. They were then classified as robust, probable sarcopenic or sarcopenic as per the European Working Group on Sarcopenia in Older People guidelines. Mixed effects models with linear splines were used to model the effect of sarcopenia status on orthostatic BP recovery, whilst controlling for potential confounders. Results Probable sarcopenia was identified in 32% of the sample and sarcopenia in 15%. Both probable and confirmed sarcopenia were independently associated with an attenuated rate of recovery of both systolic and diastolic BP in the 10–20 s period after standing. Attenuation was larger for confirmed than probable sarcopenia (systolic BP β − 0.85 and − 0.59, respectively, P < 0.01; diastolic BP β − 0.65, − 0.45, P < 0.001). Conclusion Sarcopenia was independently associated with slower BP recovery during the early post-stand period. The potentially modifiable effect of the skeletal muscle pump in orthostatic haemodynamics requires further study.

The SHARE Frailty Instrument for Primary Care was Associated with Sarcopenia, as Measured by Bioelectrical Impedance, in Falls Clinic Attendees

“…Participants stood barefoot on the scale and were asked to remove their outerwear and empty their pockets, and 0.5kg was entered as a standard tare value for clothing. We calculated ASMM (kg) by applying Sergi’s formula[ 16 ], as described elsewhere[ 17 ]. As per EWGSOP2 criteria, confirmed sarcopenia cut-off points for muscle quantity were <20 kg for ASMM in men and <15 kg for ASMM in women[ 3 ].…”

Were Frailty Identification Criteria Created Equal? A Comparative Case Study on Continuous Non-Invasively Collected Neurocardiovascular Signals during an Active Standing Test in the Irish Longitudinal Study on Ageing (TILDA)

“…The onset of the stand (i.e., the moment participants started standing up from the supine position) was determined via the height sensor data using an algorithm previously described in detail by O’Connor et al [ 44 ]. Baseline cardiovascular and neurovascular values were established by averaging readings from 60 to 30 s prior to standing, in keeping with previous investigations [ 15 , 31 , 45 ].…”

Haemodynamic Parameters Underlying the Relationship between Sarcopenia and Blood Pressure Recovery on Standing

“…Statistical analysis was performed with Stata ® version 15.1 (StataCorp LLC, College Station, TX, USA). To assess the relationship between sarcopenia and each of the haemodynamic parameters, we used multi-level mixed-effects models, as previously employed by our group and others [ 16 , 17 , 26 , 27 ]. The fixed and random effects accounted for the repeated measures within participants.…”

“…Previous research has demonstrated an association between classic OH, assessed with intermittent BP measurement, and sarcopenia [ 14 , 15 ]. We previously found an association between beat-to-beat orthostatic BP recovery and both probable sarcopenia in a population study [ 16 ] and sarcopenia in a clinical setting [ 17 ].…”