Division of Nephrology, Department of Internal Medicine.
Division of Biostatistics, Department of R&D Management, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
J Hypertens. 2020 Nov;38(11):2223-2229. doi: 10.1097/HJH.0000000000002530.
Previous cross-sectional studies suggest an association between low muscle mass and hypertension. However, whether low muscle mass predicts the development of hypertension is unknown. The aim of this study is to investigate the relationship between relative muscle mass and incident hypertension in a large prospective cohort of Korean adults.
In this prospective cohort study, we analyzed 132 324 participants without hypertension at baseline who underwent two health check-ups in 2012 and 2016 or in 2013 and 2017 with a 4-year interval. The participants were divided according to skeletal muscle mass index quartiles (Q1--Q4) according to their baseline skeletal muscle mass index [skeletal muscle mass index (%) = total skeletal muscle mass (kg)/body weight (kg) × 100). Multivariate logistic regression was used to estimate the odds ratio and 95% confidence interval for the development of hypertension after 4 years.
After 4 years, 7180 (5.43%) participants developed hypertension. The incidence rates of hypertension were 12.11, 8.58, 6.93, and 4.37% in men and 4.02, 2.29, 1.73, and 1.18% in women in Q1, Q2, Q3, and Q4, respectively. The multivariate adjusted odds ratios (95% confidence intervals) for incident hypertension in Q1, Q2, and Q3, in comparison with Q4, were 1.46 (1.3-1.63), 1.31 (1.19-1.46), and 1.26 (1.14-1.40) in men and 0.97 (0.76-1.23), 1.12 (0.90-1.38), and 1.14 (0.92-1.42) in women, respectively.
Low relative skeletal muscle mass was independently and significantly associated with the incidence of hypertension only in Korean men. Further research is required to understand the underlying mechanisms of this relationship.
先前的横断面研究表明，肌肉量低与高血压之间存在关联。然而，肌肉量低是否可预测高血压的发生尚不清楚。本研究旨在调查韩国成年人大型前瞻性队列中相对肌肉量与高血压发病之间的关系。
在这项前瞻性队列研究中，我们分析了基线时无高血压且在 2012 年和 2016 年或 2013 年和 2017 年接受了两次健康检查的 132324 名参与者，两次检查间隔为 4 年。根据基线骨骼肌质量指数（skeletal muscle mass index，SMI）四分位数（Q1-Q4）将参与者分为 4 组[SMI（%）=总骨骼肌质量（kg）/体重（kg）×100]。使用多变量逻辑回归来估计 4 年后高血压发展的比值比和 95%置信区间。
4 年后，7180 名（5.43%）参与者发生高血压。男性 Q1、Q2、Q3 和 Q4 组高血压的发生率分别为 12.11%、8.58%、6.93%和 4.37%，女性的发生率分别为 4.02%、2.29%、1.73%和 1.18%。与 Q4 相比，Q1、Q2 和 Q3 组男性高血压发病的多变量校正比值比（95%置信区间）分别为 1.46（1.3-1.63）、1.31（1.19-1.46）和 1.26（1.14-1.40），女性分别为 0.97（0.76-1.23）、1.12（0.90-1.38）和 1.14（0.92-1.42）。
相对骨骼肌质量低与男性高血压的发生独立且显著相关。需要进一步研究以了解这种关系的潜在机制。
