Malnutrition and possible sarcopenia in geriatric inpatients with H-Type hypertension: a multicenter cross-sectional study

Malnutrition and sarcopenia are highly prevalent among geriatric inpatients with H-type hypertension (hypertension combined with hyperhomocysteinemia), yet their combined burden in this population remains understudied. This study aimed to investigate the prevalence of malnutrition and possible sarcopenia, the factors associated with malnutrition, and the prevalence estimates yielded by different nutritional assessment tools in hospitalized older adults with H-type hypertension. This multicenter cross-sectional study enrolled 600 inpatients with H-type hypertension (age ≥ 60 years; plasma homocysteine > 10 µmol/L) from two tertiary hospitals in southwestern China between January 2023 and December 2024. Nutritional status was assessed with the Nutritional Risk Screening 2002 (NRS-2002) and the Mini Nutritional Assessment (MNA), and malnutrition was diagnosed according to prespecified Global Leadership Initiative on Malnutrition (GLIM) criteria (at least one phenotypic criterion—low body mass index, unintentional weight loss > 3 kg in 3 months, or low calf circumference as a proxy for reduced muscle mass—plus at least one etiologic criterion—reduced food intake or acute disease burden/inflammation). Because muscle mass was not measured, sarcopenia was evaluated as possible sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) 2019 consensus, defined as low grip strength (< 28 kg in men, < 18 kg in women) with or without reduced physical performance (6-m gait speed < 1.0 m/s). Multivariable logistic regression was used to identify factors independently associated with malnutrition. GLIM-defined malnutrition was present in 315 participants (52.5%), and possible sarcopenia in 185 (30.8%); the two conditions co-occurred in 155 participants (25.8%). The prevalence of nutritional impairment differed across tools: 8.0% were at nutritional risk by NRS-2002, whereas the MNA classified 36.2% as malnourished and 58.8% as at risk. In the multivariable model, possible sarcopenia (OR = 6.49, 95% CI: 4.11–10.25, P < 0.001) and polypharmacy (> 3 medications daily; OR = 2.60, 95% CI: 1.53–4.41, P < 0.001) were independently associated with higher odds of malnutrition, whereas adequate intake of livestock and poultry meat was associated with lower odds (OR = 0.41, 95% CI: 0.18–0.91, P = 0.029). Malnutrition and possible sarcopenia are common and interrelated among geriatric inpatients with H-type hypertension, and different nutritional tools yield markedly different prevalence estimates. The cross-sectional associations observed here—particularly between possible sarcopenia, polypharmacy, dietary protein sources, and malnutrition—are hypothesis-generating and warrant confirmation in prospective and interventional studies. Chinese Clinical Trial Registry, ChiCTR2200066867. Registered 20 December 2022.