Long-term intake of statins or renin-angiotensin system inhibitors: associations with sarcopenia-related parameters in older people
摘要
The long-term impact of common cardiovascular medications on sarcopenia in older people is unclear. The objective was to investigate whether long-term intake of statins and renin–angiotensin system inhibitors (RASi), i.e., angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB), is associated with muscle mass, strength, and physical performance in community-dwelling older adults. This exploratory observational cohort study included 1083 participants of the Berlin Aging Study II (52% women, 68.3 ± 3.5 years at baseline) with an extended follow-up of 7.4 ± 1.5 years. Statins or RASi users at baseline and follow-up were compared with nonusers. Appendicular lean mass (ALM) was measured via dual-energy X-ray absorptiometry and related to body mass index (ALM/BMI) and height2 (SMI). Hand grip strength, arm muscle quality, the Timed “up and go,” and Tinetti mobility test were additionally assessed. Adjusted linear regressions of drug use on muscle-related parameters were conducted. Statin use was not associated with any of the muscle-related outcomes. RASi use was associated with modestly lower ALM/BMI (β = −0.036, p = 0.004). Sex-stratified analyses showed that RASi use was significantly associated with lower ALM/BMI in women (β = −0.033, p = 0.029) but not in men (β = −0.037, p = 0.072), without a significant sex interaction. Long-term statin use was not associated with sarcopenia-related parameters, which is clinically reassuring. RASi use showed a modest association with lower ALM/BMI, but causality cannot be inferred because of the exploratory design. These findings warrant replication in independent cohorts and suggest that the clinical relevance of this association should be further evaluated.
Graphical Abstract