Intensive BP Control May Raise Heart Risk in Those with Low Muscle Mass: Study

For this purpose, Cox proportional hazard models and generalized linear models were employed to compare relative and absolute risks. Landmark analyses with cutoffs at 3.4 and 2 years were used to determine the time-dependent effects of intensive BP lowering on outcomes.

Key Findings

Cardiovascular Outcomes:

• In subjects with normal muscle mass, intensive BP control lowered the absolute risk of primary cardiovascular events by 5.2 events per 1,000 person-years (Hazard Ratio [HR]: 0.71; 95% Confidence Interval [CI]: 0.58–0.89).

• Subjects with low muscle mass had an increase in cardiovascular events by 11.1 per 1,000 person-years (HR: 1.72; 95% CI: 0.89–3.34), suggesting potential harm (P for interaction = 0.013).

• The higher CV risk in the low muscle mass group became statistically significant with 3.4 years of intensive BP control (P = 0.043).

Cognitive Outcomes:

• Irrespective of muscle mass, intensive BP control lowered relative and absolute risks for cognitive decline, without significant interaction between muscle mass status and cognitive gains (all P values for interaction > 0.05).

The research determines that strict BP control enhances cardiovascular risk among individuals with low muscle mass, regardless of its beneficial impact on cognition. This information highlights the need for personalized hypertension treatment strategies, particularly in older or frail individuals whose muscle mass could be reduced.

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