THE RELATIONSHIP BETWEEN DYNAPENIA AND ARTERIAL HYPERTENSION IN FEMALE PATIENTS

Highlights

The study presents an analysis of the prevalence of dynapenia, parameters characterizing the rigid-elastic properties of arterial vessels, endothelial dysfunction and inflammation in females with arterial hypertension, which made it possible to suggest pathogenetic links in their relationships.

Abstract

Aim. To assess the prevalence of dynapenia in patients with arterial hypertension (AH) and to identify possible relationships between them.

Methods. The study included 148 women of various ages. Participants were divided into four groups based on age and the presence of hypertension. The control group consisted of 30 middle-aged women without hypertension. All participants underwent a range of tests, including assessment of muscle strength, arterial wall stiffness, augmentation and reflection indices, endothelial dysfunction, fractolkine and caspase-3 levels, and walking speed.

Results. Dynapenia was detected in 25.4% of women with hypertension, and age correlated with a decrease in muscle strength. In elderly women with hypertension, the stiffness index was 10% higher than in middle-aged and senile women (p < 0.001). The augmentation index in elderly women with hypertension was 40% higher than in senile women (p < 0.01) and 63% higher than in middle-aged women (p < 0.00001). The reflectivity index in elderly women with hypertension exceeded that in middle-aged women by 17% (p < 0.05). High blood pressure contributed to changes in the elasticity of vascular walls and functional disorders. Concentrations of fractalkine (0.204 ± 0.012 pg/mL, p < 0.0005) and caspase-3 (1.109 ± 0.05 ng/mL, p < 0.000001) served as markers of chronic inflammation.

Conclusion. Dinapenia is diagnosed in a quarter of women with hypertension. Age-related changes lead to increased vascular wall rigidity, increased augmentation and reflection, development of endothelial dysfunction and inflammation, which probably initiates the process of arterial remodeling, worsening tissue metabolism and becoming an important link in the development of the cardiovascular gerontological continuum.

1. Papanova E.K., Tkacheva O.N., Kotovskaya Yu.V. Reserves for increasing life expectancy of older population in Russia. Problems of geroscience. 2023;4:249-253. (In Russian)

2. Koshelev V.A., Bogdanov L.A., Mukhamadiyarov R.A., Lazebnaya A.I., Stepanov A.D., Kutikhin A.G. Electron microscopy signs of normal and dysfunctional rat aortic endothelium. Complex Issues of Cardiovascular Diseases. 2024;13(4):191-203. doi:10.17802/2306-1278-2024-13-4-13-191-203. (In Russian)

3. Shevchenko Yu.F., Gorshunova N.K. The state of the vascular wall of arteries of different calibers in patients with arterial hypertension during aging. Interdisciplinary student scientific bulletin. 2020;5. Available at: https://stud-messenger.ru/journal/issue-12/article-248/ (accessed 15.04.2025) (In Russian)

4. Vasyuk Yu.A., Ivanova S.V., Shkolnik E.L., Kotovskaya Yu.V., Milyagin V.A., Oleynikov V.E., Orlova Ya.A., Sumin A.N., Baranov A.A., Boytsov S.A., Galyavich A.S., Kobalava Zh.D., Kozhevnikova O.V., Konradi A.O., Lopatin Yu.M., Mareev V.Yu., Novikova D.S., Oganov R.G., Rogoza A.N., Rotar O.P., Sergatskaya N.V., Skibitsky V.V. Consensus of Russian experts on the evaluation of arterial stiffness in clinical practice. Cardiovascular therapy and prevention. 2016;15(2):4-19. doi: 10.15829/1728-8800-2016-2-4-19. (In Russian)

5. Gorelik S.G., Shevchenko Yu.F., Malyutina E.S., Gorbunova E.O., Pochitaeva I.P. Pathogenetic significance of the stiffness index and augmentation index in arterial hypertension in elderly and senile women in the development of cardiovascular pathology and geriatric syndromes. Current problems of health care and medical statistics. 2021;2:27-43. doi: 10.24412/2312-2935-2021-2-27-43. (In Russian)

6. Skripal A.V., Bakhmetyev A.S., Brilenok N.B., Dobdin S.Yu., Sagaidachnyi A.A., Baatyrov R.T., Usanov A.D., Tikhonova A.S. Reflection index of the pulse wave for young athletes. Izvestiya of Saratov university. New series. Series: physics. 2020;2(20):125-133. doi: 10.18500/1817-3020-2020-20-2-125-133. (In Russian)

7. Grachev D.S., Petrov V.S. Parameters of daily monitoring of arterial pressure in patients of senile age with chronic heart failure depending on vascular stiffness. Eruditio Juvenium. 2023;4(11):483-492. doi: 10.23888/HMJ2023114483-492. (In Russian)

8. Gapon L.I. Hypertension and arterial wall stiffness in clinical practice: literature review. Russian journal of cardiology. 2024;5(29):96-104. doi: 10.15829/1560-4071-2024-5924. (In Russian)

9. Khazova E.V., Smetanina E.D., Malkova M.I. Frailty in patients with cardiovascular diseases: issues of epidemiology, diagnosis, prognosis. Medical almanac. 2023;3(76):98-106. (In Russian)

10. Bazdyrev E.D., Terentyeva N.A., Krivoshapova K. E., Masenko V.L., Wegner E.A., Kokov A.N., Pomeshkina S.A., Barbarash O. L. Prevalence of Musculoskeletal Disorders in Patients with Coronary Artery Disease. Rational Pharmacotherapy in Cardiology 2021;17(3):369-375. DOI:10.20996/1819-6446-2021-06-03. (In Russian)

11. Sivritepe R., Siyer O.K., Tiril S.M., Basat S.U. Do we know about dynapenia? North Clin Istanb. 2024; 11(6): 593–599. doi: 10.14744/nci.2024.48642.

12. Silva R.R., Galvão L.L., Meneguci J., Santos D.A.T., Virtuoso Júnior J.S., Tribess S. Dynapenia in all-cause mortality and its relationship with sedentary behavior in community-dwelling older adults. Sports Med Health Sci. 2022;4:253–9. doi: 10.1016/j.smhs.2022.09.002.

13. Shevchenko Yu.F., Gorelik S.G., Ilnitski A.N., Bokova N.A. Vascular wall stiffness and dina / sarcopenia in elderly and senile women with arterial hypertension. Current problems of health care and medical statistics. 2022;1:232-253. doi: 10.24412/2312-2935-2022-1-237-258. (In Russian)

14. Terentyeva N.A., Galimova N.A., Bazdyrev E.D., Krivoshapova K.E., Tsygankova D.P., Ivanov S.V., Masenko V.L., Kokov A.N., Barbarash O.L. Risk factors for unfavorable prognosis in patients with coronary artery disease and age-related disorders undergoing coronary artery bypass grafting. Complex Issues of Cardiovascular Diseases. 2022;11(4):13-24. doi: 10.17802/2306-1278-2022-11-4-13-24. (In Russian)

15. Choi Y.A., Lee J.S., Kim Y.H. Association between physical activity and dynapenia in older adults with COPD: a nationwide survey. Sci Rep. 2022;12:7480. doi: 10.1038/s41598-022-11504-1.

16. Ji Y., Li M., Chang M., Liu R., Qiu J., Wang K., Deng C., Shen Y., Zhu J., Wang W., Xu L., Sun H. Inflammation: roles in skeletal muscle atrophy. Antioxidants (Basel) 2022; 11: 1686. doi: 10.3390/antiox11091686.

17. Kishimoto. Т., Onishi H., Tsubouchi H., Mizukami Y., Kubota M., Ikeda R., Konoshita N., Tanaka T., Kobayashi K., Hayashi H., Yamamura O. Association between upper limb muscle quality and knee osteoarthritis in dynapenia: an observational cross-sectional study. J Clin Biochem Nutr. 2024; 75(2): 145–152. doi: 10.3164/jcbn.24-58

18. Gungor O., Ulu S., Hasbal N.B., Anker S.D., Kalantar-Zadeh K. Effects of hormonal changes on sarcopenia in chronic kidney disease: where are we now and what can we do? J Cachexia Sarcopenia Muscle. 2021;12:1380–92. doi: 10.1002/jcsm.12839

19. Gupta P., Kumar S. Sarcopenia and endocrine ageing: are they related? Cureus. 2022;14:e28787. doi: 10.7759/cureus.28787.

20. Diaz-Morales N., Rovira-Llopis S., Escribano-Lopez I., Bañuls C., Lopez-Domenech S., Falcón R., de Maranon A.M., Sola E., Jover A., Roldan I., Diez J.L., Rocha M., Hernández-Mijares A., Víctor V.M. Role of oxidative stress and mitochondrial dysfunction in skeletal muscle in type 2 diabetic patients. Curr Pharm Des. 2016;22:2650–6. doi: 10.2174/1381612822666160217142949

21. Chainy G.B.N., Sahoo D.K. Hormones and oxidative stress: an overview. Free Radic Res. 2020;54:1–26. doi: 10.1080/10715762.2019.1702656

22. Rezuş E., Burlui A., Cardoneanu A., Rezuş C., Codreanu C., Pârvu M., Rusu Zota G., Tamba B.I. Inactivity and skeletal muscle metabolism: a vicious cycle in old age. Int J Mol Sci 2020; 21:592. doi: 10.3390/ijms21020592.

23. Sandvik M.K., Watne L.O., Brugård A., Wang-Hansen M.S., Kersten H. Association between psychotropic drug use and handgrip strength in older hospitalized patients. Eur Geriatr Med. 2021;12:1213–20. doi: 10.1007/s41999-021-00511-6.

24. Treuil M., Mahmutovic M., Di Patrizio P., Nguyen-Thi P.L., Quilliot D. Assessment of dynapenia and undernutrition in primary care, a systematic screening study in community medicine. Clin Nutr ESPEN. 2023;57:561–8. doi: 10.1016/j.clnesp.2023.08.003.