Associations of Sarcopenia and Its Components With Cardiovascular Risk: Five-Year Longitudinal Evidence From China Health and Retirement Longitudinal Study

Chen, Y, Zhong, Z, Prokopidis, K, Gue, Y, McDowell, G ORCID: 0000-0002-2880-5236, Liu, Y, Ditchfield, C, Alobaida, M, Huang, B and Lip, GYH ORCID: 0000-0002-7566-1626 (2025) Associations of Sarcopenia and Its Components With Cardiovascular Risk: Five-Year Longitudinal Evidence From China Health and Retirement Longitudinal Study. Journal of the American Heart Association, 14 (13).

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Abstract

Background Sarcopenia, an age‐related condition, has an unclear association with cardiovascular disease (CVD) risk. We aimed to analyze whether sarcopenia and its individual components are associated with new‐onset CVD in middle‐aged and older adults. Methods and Results Data were derived from the China Health and Retirement Longitudinal Study, with sarcopenia defined by the Asian Working Group for Sarcopenia 2019 criteria. The primary outcome was composite CVD, comprising heart disease and stroke. Multivariable Cox proportional hazards regression analysis and Fine–Gray subdistribution hazards models were used to calculate hazard ratios (HRs), subdistribution hazard ratios (SHRs), and 95% CIs. A total of 10 649 participants (mean age 64.5±10.7 years, 47.6% male) were included. During mean follow‐up of 4.60±1.06 years, there were 1649 (15.5%) cases of new‐onset CVD. Possible sarcopenia was linked to increased new‐onset composite CVD risk (HR, 1.21 [95% CI, 1.06–1.37]; SHR, 1.20 [95% CI, 1.05–1.35]), whereas sarcopenia and severe sarcopenia showed no association. Restricted cubic spline analysis revealed that 5‐time chair stand test (5‐CST) was associated with new‐onset composite CVD, with significant sex‐specific interaction (P‐for‐interaction=0.001). Compared with 5‐CST≤9.0 s, higher risk of new‐onset composite CVD was observed in men for 9.0 s<5‐CST≤15.0 s (HR, 1.36 [95% CI, 1.16–1.59]; SHR, 1.34 [95% CI, 1.15–1.56]) and 5‐CST>15.0 s (HR, 2.19 [95% CI, 1.65–2.90]; SHR, 2.00 [95% CI, 1.53–2.63]). Among women, 5‐CST>8.5 s had higher risk of new‐onset composite CVD compared with 5‐CST≤8.5 s (HR, 1.26 [95% CI, 1.09–1.45]; SHR, 1.25 [95% CI, 1.09–1.43]). Conclusion Possible sarcopenia was associated with increased risk of new‐onset composite CVD, suggesting that progression to definite sarcopenia may not parallel cardiovascular risk. Longer 5‐CST was linked to higher risk of new‐onset composite CVD, with sex‐specific association.

Item Type:	Article
Uncontrolled Keywords:	32 Biomedical and Clinical Sciences; 3201 Cardiovascular Medicine and Haematology; Aging; Heart Disease; Cardiovascular; Prevention; 2.1 Biological and endogenous factors; Cardiovascular; 3 Good Health and Well Being; 1102 Cardiorespiratory Medicine and Haematology; 3201 Cardiovascular medicine and haematology
Subjects:	Q Science > QH Natural history > QH301 Biology
Divisions:	Pharmacy and Biomolecular Sciences
Publisher:	Wiley
Date of acceptance:	28 May 2025
Date of first compliant Open Access:	2 July 2025
Date Deposited:	02 Jul 2025 10:38
Last Modified:	03 Jul 2025 12:45
DOI or ID number:	10.1161/jaha.124.040099
URI:	https://researchonline.ljmu.ac.uk/id/eprint/26691

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