Lower muscle tissue is associated with higher pulse wave velocity: A systematic review and meta-analysis of observational study data

Muscle loss and arterial stiffness share common risk factors and are commonly seen in the elderly. We aimed to synthesise the existing literature on studies that have examined this association. We searched electronic databases for studies reporting correlations or associations between a measure of muscle tissue and a measure of arterial stiffness. Meta-analysis was conducted using Fisher's Z-transformed r-correlation (r(Z)) values. Pooled weighted r(Z) and 95% confidence intervals were calculated in an inverse-variance, random-effects model. Heterogeneity was assessed by the inconsistency index (I-2). Study quality was assessed on a checklist using items from validated quality appraisal guidelines. 1195 records identified, 21 satisfied our inclusion criteria totalling 8558 participants with mean age 52 +/- 4years (range 23-74). Most studies reported an inverse relationship between muscle tissue and arterial stiffness. Eight studies had data eligible for meta-analysis. Muscle tissue was inversely associated with pulse wave velocity in healthy individuals [r(Z)=-.15 (95% CI -0.24, -0.07); P=.0006; I-2=85%; n=3577] and in any population [r(Z)=-.18 (-0.26, -0.10); P<.0001; I-2=81%; n=3930]. In a leave-one-out sensitivity analysis, the results remained unchanged. Lower muscle tissue was associated with arterial stiffness. Studies were limited by cross-sectional design. Cardiovascular risk monitoring may be strengthened by screening for low muscle mass and maintaining muscle mass may be a primary prevention strategy.