{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T13:13:31Z","timestamp":1788786811780,"version":"build-2803163510"},"reference-count":46,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T00:00:00Z","timestamp":1736899200000},"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. Public Health"],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Sarcopenia, sarcopenic obesity, and hypertension are all widespread public health problems in middle-aged and older populations, and their association is controversial. The purpose of this study is to analyze the relationship between obesity, sarcopenia, and sarcopenic obesity with hypertension in a middle-aged and older community population in China through a large-scale longitudinal design.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this cohort study with 7\u202fyears of follow-up, the study population was drawn from participants in the China Health and Retirement Longitudinal Study (CHARLS) in 2011 and followed up in 2013, 2015, and 2018. The diagnostic criteria for sarcopenia were based on the consensus recommendations issued by the Asian Working Group for Sarcopenia (AWGS) in 2019. The diagnosis of obesity is based on body mass index and waist circumference. Sarcopenic obesity is defined as the coexistence of sarcopenia and obesity. Cox proportional risk regression models were used to analyze the association of obesity, sarcopenia, and sarcopenic obesity with hypertension.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 7,301 participants with a mean age of 58\u202f\u00b1\u202f8.8 were enrolled in the study, and 51.9% females. A total of 1,957 participants had a new onset of hypertension after 7\u202fyears of follow-up. In a multifactorial analysis, obesity and sarcopenic obesity were associated with hypertension; hazard ratios (HRs) and 95% confidence intervals (CIs) were 1.67 (1.43\u202f~\u202f1.96), <jats:italic>p<\/jats:italic>\u202f&amp;lt;\u202f0.001, and 1.61 (1.09\u202f~\u202f2.37), <jats:italic>p<\/jats:italic>\u202f=\u202f0.017. Sarcopenia and hypertension were not significantly associated; the HR and 95% CI were 1.17 (0.9\u202f~\u202f1.52), <jats:italic>p<\/jats:italic>\u202f=\u202f0.23.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There is no significant correlation between sarcopenia and hypertension, but obesity and sarcopenic obesity increase the risk of hypertension. Targeted management of middle-aged and older people with sarcopenic obesity is needed in public health efforts.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2024.1479169","type":"journal-article","created":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:12:10Z","timestamp":1736917930000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":7,"title":["Sarcopenia is not associated with hypertension, but sarcopenic obesity increases risk of hypertension: a 7-year cohort study"],"prefix":"10.3389","volume":"12","author":[{"given":"Runfen","family":"Du","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junchao","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunda","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guihua","family":"Jiang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiping","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,1,15]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"1148","DOI":"10.1097\/hjh.0000000000002021","article-title":"The global burden of hypertension exceeds 1.4 billion people: should a systolic blood pressure target below 130 become the universal standard?","volume":"37","author":"Egan","year":"2019","journal-title":"J Hypertens"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"1949","DOI":"10.1161\/hypertensionaha.121.18884","article-title":"How to improve awareness, treatment, and control of hypertension in Africa, and how to reduce its consequences: a call to action from the world hypertension league","volume":"79","author":"Parati","year":"2022","journal-title":"Hypertension"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1167\/iovs.62.9.28","article-title":"Hypertensive retinopathy and the risk of stroke among hypertensive adults in China","volume":"62","author":"Chen","year":"2021","journal-title":"Invest Ophthalmol Vis Sci"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1223","DOI":"10.1016\/S0140-6736(20)30752-2","article-title":"Global burden of 87 risk factors in 204 countries and territories, 1990-2019: a systematic analysis for the global burden of disease study 2019","volume":"396","author":"Murray","year":"2020","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1016\/j.explore.2020.05.010","article-title":"Healthy beat acupunch exercise program: validation and feasibility study for older adults with reduced physical capacity or probable sarcopenia","volume":"17","author":"Jones","year":"2021","journal-title":"Explore"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"2087","DOI":"10.1186\/s12889-023-17007-6","article-title":"Association between relative muscle strength and hypertension in middle-aged and older Chinese adults","volume":"23","author":"Luo","year":"2023","journal-title":"BMC Public Health"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"1102","DOI":"10.1017\/s0007114520002172","article-title":"Sarcopenic obesity in ageing: cardiovascular outcomes and mortality","volume":"124","author":"Atkins","year":"2020","journal-title":"Br J Nutr"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e13534","DOI":"10.1111\/obr.13534","article-title":"Deciphering the \"obesity paradox\" in the elderly: a systematic review and Meta-analysis of Sarcopenic obesity","volume":"24","author":"Liu","year":"2023","journal-title":"Obes Rev"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1007\/s11892-023-01522-2","article-title":"Sarcopenic obesity and Cardiometabolic health and mortality in older adults: a growing health concern in an ageing population","volume":"23","author":"Wannamethee","year":"2023","journal-title":"Curr Diab Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"4205","DOI":"10.3390\/nu14194205","article-title":"The applicability of the Espen and Easo-defined diagnostic criteria for Sarcopenic obesity in Japanese patients after stroke: prevalence and association with outcomes","volume":"14","author":"Yoshimura","year":"2022","journal-title":"Nutrients"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1111\/ggi.14442","article-title":"Implication of diet and exercise on the management of age-related sarcopenic obesity in Asians","volume":"22","author":"Kim","year":"2022","journal-title":"Geriatr Gerontol Int"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1038\/s41574-018-0059-4","article-title":"Inflammaging: a new immune-metabolic viewpoint for age-related diseases","volume":"14","author":"Franceschi","year":"2018","journal-title":"Nat Rev Endocrinol"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1016\/j.tem.2016.09.005","article-title":"Inflammaging and 'Garb-Aging'","volume":"28","author":"Franceschi","year":"2017","journal-title":"Trends Endocrinol Metab"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"582","DOI":"10.1038\/ncpneph0283","article-title":"Mechanisms of disease: oxidative stress and inflammation in the pathogenesis of hypertension","volume":"2","author":"Vaziri","year":"2006","journal-title":"Nat Clin Pract Nephrol"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"537","DOI":"10.1097\/00004872-199917040-00012","article-title":"Upregulation of renin-angiotensin system during differentiation of monocytes to macrophages","volume":"17","author":"Okamura","year":"1999","journal-title":"J Hypertens"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1038\/s41581-019-0145-4","article-title":"Obesity, kidney dysfunction and hypertension: mechanistic links","volume":"15","author":"Hall","year":"2019","journal-title":"Nat Rev Nephrol"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1161\/circresaha.119.312321","article-title":"Obesity, hypertension, and cardiac dysfunction: novel roles of Immunometabolism in macrophage activation and inflammation","volume":"126","author":"Mouton","year":"2020","journal-title":"Circ Res"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"991","DOI":"10.1161\/circresaha.116.305697","article-title":"Obesity-induced hypertension: interaction of neurohumoral and renal mechanisms","volume":"116","author":"Hall","year":"2015","journal-title":"Circ Res"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"526","DOI":"10.1002\/oby.21356","article-title":"Mid-adulthood cardiometabolic risk factor profiles of Sarcopenic obesity","volume":"24","author":"Ma","year":"2016","journal-title":"Obesity"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.archger.2014.03.012","article-title":"Sarcopenia and Sarcopenic obesity classifications and Cardiometabolic risks in older women","volume":"59","author":"dos Santos","year":"2014","journal-title":"Arch Gerontol Geriatr"},{"key":"ref21","doi-asserted-by":"publisher","first-page":"705055","DOI":"10.3389\/fpubh.2021.705055","article-title":"Association of Obesity, sarcopenia, and Sarcopenic obesity with hypertension in adults: A Cross-sectional study from Ravansar, Iran during 2014-2017","volume":"9","author":"Pasdar","year":"2021","journal-title":"Front Public Health"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China health and retirement longitudinal study (Charls)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"1495","DOI":"10.1016\/j.ijsu.2014.07.013","article-title":"The strengthening the reporting of observational studies in epidemiology (Strobe) statement: guidelines for reporting observational studies","volume":"12","author":"von Elm","year":"2014","journal-title":"Int J Surg"},{"key":"ref24","first-page":"1","article-title":"The guidelines for prevention and control of overweight and obesity in Chinese adults","volume":"17","author":"Chen","year":"2004","journal-title":"Biomed Environ Sci"},{"key":"ref25","doi-asserted-by":"publisher","first-page":"191","DOI":"10.1017\/s0954422410000120","article-title":"Optimal cut-off values and population means of waist circumference in different populations","volume":"23","author":"Wang","year":"2010","journal-title":"Nutr Res Rev"},{"key":"ref26","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1016\/j.jamda.2019.12.012","article-title":"Asian working Group for Sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment","volume":"21","author":"Chen","year":"2020","journal-title":"J Am Med Dir Assoc"},{"key":"ref27","first-page":"551","article-title":"Anthropometric equation for estimation of appendicular skeletal muscle mass in Chinese adults","volume":"20","author":"Wen","year":"2011","journal-title":"Asia Pac J Clin Nutr"},{"key":"ref28","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1159\/000521241","article-title":"Definition and diagnostic criteria for Sarcopenic obesity: Espen and Easo consensus statement","volume":"15","author":"Donini","year":"2022","journal-title":"Obes Facts"},{"key":"ref29","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1016\/j.clnu.2021.11.014","article-title":"Definition and diagnostic criteria for Sarcopenic obesity: Espen and Easo consensus statement","volume":"41","author":"Donini","year":"2022","journal-title":"Clin Nutr"},{"key":"ref30","doi-asserted-by":"publisher","first-page":"591","DOI":"10.1016\/s0140-6736(07)61299-9","article-title":"Essential Hypertension","volume":"370","author":"Messerli","year":"2007","journal-title":"Lancet"},{"key":"ref31","doi-asserted-by":"publisher","first-page":"161","DOI":"10.2174\/1573402114666181031145341","article-title":"Association between adiposity indices and blood pressure is stronger in Sarcopenic obese women","volume":"15","author":"Dutra","year":"2019","journal-title":"Curr Hypertens Rev"},{"key":"ref32","doi-asserted-by":"publisher","first-page":"1963","DOI":"10.2147\/dmso.S308387","article-title":"The association between Sarcopenic obesity and hypertension, diabetes, and abnormal lipid metabolism in Chinese adults","volume":"14","author":"Yin","year":"2021","journal-title":"Diabetes Metab Syndr Obes"},{"key":"ref33","doi-asserted-by":"publisher","first-page":"e067425","DOI":"10.1136\/bmjopen-2022-067425","article-title":"Prevalence of possible sarcopenia in community-dwelling older Chinese adults: a cross-sectional study","volume":"12","author":"Yao","year":"2022","journal-title":"BMJ Open"},{"key":"ref34","doi-asserted-by":"publisher","first-page":"e86902","DOI":"10.1371\/journal.pone.0086902","article-title":"Sarcopenia as a determinant of blood pressure in older Koreans: findings from the Korea National Health and nutrition examination surveys (Knhanes) 2008-2010","volume":"9","author":"Han","year":"2014","journal-title":"PLoS One"},{"key":"ref35","doi-asserted-by":"publisher","first-page":"1356878","DOI":"10.3389\/fpubh.2024.1356878","article-title":"The diagnostic agreement of Sarcopenic obesity with different definitions in Chinese community-dwelling middle-aged and older adults","volume":"12","author":"Hu","year":"2024","journal-title":"Front Public Health"},{"key":"ref36","doi-asserted-by":"publisher","first-page":"789","DOI":"10.1186\/s12877-023-04510-z","article-title":"Relationship between obesity indicators and hypertension-diabetes comorbidity in an elderly population: A retrospective cohort study","volume":"23","author":"Li","year":"2023","journal-title":"BMC Geriatr"},{"key":"ref37","doi-asserted-by":"publisher","first-page":"1142","DOI":"10.1161\/hypertensionaha.107.105205","article-title":"Gender difference in blood pressure control and cardiovascular risk factors in Americans with diagnosed hypertension","volume":"51","author":"Ong","year":"2008","journal-title":"Hypertension"},{"key":"ref38","doi-asserted-by":"publisher","first-page":"331","DOI":"10.1016\/j.maturitas.2011.01.014","article-title":"Menopause and sarcopenia: a potential role for sex hormones","volume":"68","author":"Messier","year":"2011","journal-title":"Maturitas"},{"key":"ref39","doi-asserted-by":"publisher","first-page":"3855","DOI":"10.1210\/jc.2011-0312","article-title":"Higher testosterone levels are associated with less loss of lean body mass in older men","volume":"96","author":"LeBlanc","year":"2011","journal-title":"J Clin Endocrinol Metab"},{"key":"ref40","doi-asserted-by":"publisher","first-page":"24","DOI":"10.1038\/ijir.2008.60","article-title":"Are declining testosterone levels a major risk factor for ill-health in aging men?","volume":"21","author":"Yeap","year":"2009","journal-title":"Int J Impot Res"},{"key":"ref41","doi-asserted-by":"publisher","first-page":"200","DOI":"10.1016\/j.arr.2016.09.008","article-title":"Sarcopenic obesity or obese sarcopenia: a cross talk between age-associated adipose tissue and skeletal muscle inflammation as a main mechanism of the pathogenesis","volume":"35","author":"Kalinkovich","year":"2017","journal-title":"Ageing Res Rev"},{"key":"ref42","doi-asserted-by":"publisher","first-page":"434","DOI":"10.1007\/s11906-008-0082-2","article-title":"Leptin and mechanisms of endothelial dysfunction and cardiovascular disease","volume":"10","author":"Knudson","year":"2008","journal-title":"Curr Hypertens Rep"},{"key":"ref43","doi-asserted-by":"publisher","first-page":"1881","DOI":"10.1007\/s41999-024-01039-1","article-title":"The combined effect of diabetes mellitus and sarcopenia on depression and cognitive function: insights from the Charls cohort, 2011-2020","volume":"15","author":"Chen","year":"2024","journal-title":"Eur Geriatr Med"},{"key":"ref44","doi-asserted-by":"publisher","first-page":"1915","DOI":"10.1002\/jcsm.13541","article-title":"Bidirectional transitions of sarcopenia states in older adults: the longitudinal evidence from Charls","volume":"15","author":"Luo","year":"2024","journal-title":"J Cachexia Sarcopenia Muscle"},{"key":"ref45","doi-asserted-by":"publisher","first-page":"101264","DOI":"10.1016\/j.eclinm.2021.101264","article-title":"Association between sarcopenia and cardiovascular disease among middle-aged and older adults: findings from the China health and retirement longitudinal study","volume":"44","author":"Gao","year":"2022","journal-title":"EClinicalMedicine"},{"key":"ref46","doi-asserted-by":"publisher","first-page":"3097","DOI":"10.3390\/nu15143097","article-title":"Longitudinal association between uric acid and incident sarcopenia","volume":"15","author":"Zhou","year":"2023","journal-title":"Nutrients"}],"container-title":["Frontiers in Public Health"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1479169\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,15]],"date-time":"2025-01-15T05:12:16Z","timestamp":1736917936000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fpubh.2024.1479169\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":46,"alternative-id":["10.3389\/fpubh.2024.1479169"],"URL":"https:\/\/doi.org\/10.3389\/fpubh.2024.1479169","relation":{},"ISSN":["2296-2565"],"issn-type":[{"value":"2296-2565","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,15]]},"article-number":"1479169"}}