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DOI: 10.18413/2658-6533-2023-9-3-0-9

Effects of sarcopenia on hemodynamics in patients with cardiovascular diseases and pathological aging

Background: The number of patients with comorbid pathology and geriatric syndromes, particularly sarcopenia, increases with age. For the diagnosis of sarcopenia, the method of bioimpedance analysis with an assessment of hemodynamic parameters can be used, which is important for the selection of hypotensive therapy in outpatient settings. The aim of the study: To study the features of hemodynamics in mature and elderly patients with sarcopenia for optimizing the tactics of the use of antihypertensive drugs. Materials and methods: We examined 150 male and female patients divided into 2 age groups: 40-59 years and 60-74 years. Recommendations of the European (2018) and Russian Society of Cardiology (2019, 2020.) were used for the diagnosis of hypertension and coronary heart disease. Sarcopenia and its stages were determined according to the criteria of EWSGOP 1 with the recommendations of EWSGOP 2. The parameters of central (cardiac output (CO), cardiac shock volume (CSV)), peripheral hemodynamics (SAD, DAD, mean and pulse BP) were studied using a pulse wave on the MultiscanBC-OXi (Russia) bioimpedance analyzer. Results: Comparative characteristics of patients with comorbid pathology in two age groups showed that they differed in the prevalence of coronary heart disease and age-related hypertension (p<0.05). Assessment of hemodynamic parameters in mature and elderly patients, depending on the presence or absence demonstrated that individuals with sarcopenia had higher blood pressure figures (SAD, DAD, PAD, Cp. AD, p<0.05). The effect of sarcopenia was also expressed in an increase in SO and CSV both in adulthood and in old age, compared with patients without sarcopenia (p<0.05), which is an additional indication for the appointment of beta-blockers to reduce hypersympathicotonia. Conclusion: The presence of sarcopenia in patients over 40 years of age affects the parameters of hemodynamics, which should be taken into account when prescribing antihypertensive therapy. The values of SO and CSV in patients with sarcopenia may be additional indications for the inclusion of beta-blockers in combination therapy of hypertension.

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