Is more muscle mass linked to less hypertension? Exploring sex-specific effects and the role of body composition in older European adults

Abstract Aim This study aimed to investigate the association between skeletal muscle mass and hypertension in aging men and women, and to assess whether this relationship differs by sex. Subject and methods We included data from the European Community Respiratory Health Survey (ECRHS) IV, comprising body composition, anthropometric, demographic, medical, and lifestyle information. Skeletal muscle mass was assessed by bioimpedance analyses and expressed as total muscle mass, percentage of body weight or indexed to height. Logistic regression models were used to evaluate the associations with hypertension, adjusting for body composition and other covariates. Results In a large cohort of 872 middle-aged and older Europeans, we found that skeletal muscle mass—whether as total, relative to body weight or indexed to height—was inversely associated with hypertension in body composition-adjusted models, particularly in women. Results varied with how skeletal muscle was expressed as well as which adjustment strategy was used. Conclusion Skeletal muscle mass may be protective against the development of hypertension in older adulthood, particularly in women. These findings highlight the need for considering sex differences, modeling approaches, and age group when investigating the relationship between skeletal muscle mass and hypertension.