{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T15:15:23Z","timestamp":1788966923056,"version":"build-2803163510"},"reference-count":38,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T00:00:00Z","timestamp":1788739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Nutr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sarcopenia and sarcopenic obesity have been increasingly investigated in relation to hypertension, but observational findings remain inconsistent. This systematic review and meta-analysis aimed to quantitatively synthesize the associations of sarcopenia and sarcopenic obesity with hypertension in adults.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>PubMed, Embase, the Cochrane Library, and Web of Science were searched from inception to July 20, 2026. Observational studies reporting associations of sarcopenia or sarcopenic obesity with hypertension were included. Effect estimates were pooled using random-effects restricted maximum likelihood models. Subgroup analyses were conducted according to study design, age, sarcopenia diagnostic criteria, and hypertension definition. Exploratory stratified analyses were additionally performed according to effect measure type [odds ratio (OR) versus hazard ratio (HR)]. The protocol was registered in PROSPERO (CRD420261393787).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nine studies involving 346,748 participants were included. Sarcopenia was significantly associated with hypertension (pooled relative effect estimate: 1.45, 95% CI: 1.08\u20131.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.01; I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f95.51%). Sarcopenic obesity was also significantly associated with hypertension (pooled relative effect estimate: 2.49, 95% CI: 1.75\u20133.56;\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001; I\n                      <jats:sup>2<\/jats:sup>\n                      \u202f=\u202f86.85%). Subgroup analyses generally showed associations in the same direction, although most tests for subgroup differences were not statistically significant. Exploratory analyses stratified by effect measure type did not identify statistically significant subgroup differences for sarcopenia (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.10) or sarcopenic obesity (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.26), although the HR strata were based on a limited number of studies. Leave-one-out sensitivity analyses retained the direction and statistical significance of the pooled associations. Because of the limited number of studies, publication bias assessments were considered exploratory.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Sarcopenia and sarcopenic obesity were both significantly associated with hypertension. However, substantial heterogeneity and the observational nature of the evidence warrant cautious interpretation and preclude causal inference. Further prospective studies using harmonized definitions and diverse populations are needed to clarify temporality, sources of heterogeneity, and potential clinical implications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic review registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/PROSPERO\/view\/CRD420261393787<\/jats:ext-link>\n                      , identifier CRD420261393787.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fnut.2026.1881526","type":"journal-article","created":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T04:23:16Z","timestamp":1788754996000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Associations of sarcopenia and sarcopenic obesity with hypertension: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"13","author":[{"given":"Xiang","family":"Li","sequence":"first","affiliation":[{"name":"School of Leisure and Sports, Chengdu Sport University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yannan","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Acupuncture and Tuina, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinqing","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Leisure and Sports, Ginkgo College of Hospitality Management","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zexing","family":"Wen","sequence":"additional","affiliation":[{"name":"School of Leisure and Sports, Chengdu Sport University","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yujian","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Xie","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health, Chengdu University of Traditional Chinese Medicine","place":["Chengdu, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,7]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.cell.2022.11.001","article-title":"Hallmarks of aging: an expanding universe","volume":"186","author":"L\u00f3pez-Ot\u00edn","year":"2023","journal-title":"Cell"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"2001","DOI":"10.1186\/s12889-023-16950-8","article-title":"The association of body composition and fat distribution with hypertension in community-dwelling older adults: the Bushehr elderly health (beh) program","volume":"23","author":"Khaleghi","year":"2023","journal-title":"BMC Public Health"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"809","DOI":"10.1186\/s12891-023-06934-5","article-title":"The association of body composition and fat distribution with dysmobility syndrome in community-dwelling older adults: Bushehr elderly health (beh) program","volume":"24","author":"Khaleghi","year":"2023","journal-title":"BMC Musculoskelet Disord"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"957","DOI":"10.1016\/S0140-6736(21)01330-1","article-title":"Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants","volume":"398","year":"2021","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"3912","DOI":"10.1093\/eurheartj\/ehae178","article-title":"ESC guidelines for the management of elevated blood pressure and hypertension","volume":"45","author":"Mcevoy","year":"2024","journal-title":"Eur Heart J"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1056\/NEJMoa1803180","article-title":"Effect of systolic and diastolic blood pressure on cardiovascular outcomes","volume":"381","author":"Flint","year":"2019","journal-title":"N Engl J Med"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1161\/HYP.0000000000000203","article-title":"Medication adherence and blood pressure control: a scientific statement from the american heart 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