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Long-term Intake of Statins or Renin-Angiotensin-System Inhibitors and Their Association With Parameters of Sarcopenia in Older Persons

Aydogan, T.; Toepfer, S.; Spira, D.; Kreutz, R.; Demuth, I.

2025-08-03 geriatric medicine
10.1101/2025.08.01.25332603 medRxiv
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BackgroundThe impact of common cardiovascular medications on sarcopenia in older persons is unclear. The aim of this population-based cohort study was to investigate the relationship between long-term intake of statins and renin-angiotensin-system inhibitors (RASi), i.e. angiotensin-converting enzyme inhibitors (ACEi) or angiotensin receptor blockers (ARB), and established muscle mass and function parameters. MethodsCommunity dwelling older adults (n=1,083, 52% women, 68.3 {+/-} 3.5 years at baseline) from the Berlin Aging Study II (BASE-II) with a mean follow-up of 7.4 {+/-} 1.5 years were analyzed. Users of statins or RASi were compared to non-users. 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 (HGS) was assessed and related to arm muscle mass. The Timed "Up and Go" and Tinetti mobility test were used to evaluate physical performance. Adjusted linear regressions of drug use on muscle mass, strength, and function were conducted. ResultsIn linear regression analysis, statin use was neither associated with any of the muscle mass nor with function parameters. In contrast, RASi users had significantly lower ALM/BMI ({beta}= -0.036, p=0.004). When stratified by sex, the use of RASi was significantly associated with lower ALM/BMI in women ({beta}= -0.033, p=0.029) but not in men ({beta}= -0.037, p=0.072). ConclusionAlthough statins have been associated with adverse muscle events, their use in older adults was not significantly associated with muscle mass or function parameters. In contrast, use of RASi was associated with a lower muscle mass phenotype. Graphical Abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=200 SRC="FIGDIR/small/25332603v1_ufig1.gif" ALT="Figure 1"> View larger version (60K): org.highwire.dtl.DTLVardef@3f6e5aorg.highwire.dtl.DTLVardef@660b27org.highwire.dtl.DTLVardef@16655a7org.highwire.dtl.DTLVardef@1814dd0_HPS_FORMAT_FIGEXP M_FIG C_FIG

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