Angiotensin II receptor blocker and statin combination therapy associated with higher skeletal muscle index in patients with cardiovascular disease: A retrospective study

J Clin Pharm Ther. 2022 Jan;47(1):89-96. doi: 10.1111/jcpt.13540. Epub 2021 Oct 20.

Abstract

What is known and objective: Reduction in skeletal muscle mass is the most important component in diagnosing sarcopenia. Ageing and chronic heart failure due to cardiovascular diseases (CVDs) accelerate the reduction of skeletal muscles. However, there are no currently available drugs that are effective for sarcopenia. The purpose of this study was to explore the association between prescribed medications and skeletal muscle mass in patients with CVD.

Methods: This was a single-centre, retrospective, cross-sectional study. The subjects were 636 inpatients with CVD who took prescribed medicines for at least 4 weeks at the time of admission. Skeletal muscle volume was assessed using a bioelectrical impedance assay.

Results and discussion: Single regression analysis showed that 10 and 3 medications were positively and negatively associated with skeletal muscle index (SMI), respectively. Stepwise multivariate regression analysis revealed that angiotensin II receptor blocker (ARB)/statin combination, dipeptidyl peptidase-4 inhibitor, and antihyperuricemic agents were positively associated with SMI while diuretics and antiarrhythmic agents were negatively associated with SMI. After adjustment using propensity score matching, the SMI was found to be significantly higher in ARB/statin combination users than in non-users.

What is new and conclusion: Combination use of ARB/statin was associated with a higher SMI in patients with CVD. A future randomised, controlled trial is warranted to determine whether the ARB/statin combination will increase the SMI and prevent sarcopenia in patients with CVD.

Keywords: angiotensin II receptor blocker; cardiovascular disease; sarcopenia; skeletal muscle; statin.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Aging / physiology
  • Angiotensin Receptor Antagonists / administration & dosage
  • Angiotensin Receptor Antagonists / pharmacology*
  • Anti-Arrhythmia Agents / pharmacology
  • Cardiovascular Diseases / drug therapy
  • Cross-Sectional Studies
  • Diuretics / pharmacology
  • Drug Tolerance
  • Female
  • Gout Suppressants / pharmacology
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / pharmacology*
  • Male
  • Middle Aged
  • Muscle, Skeletal / drug effects*
  • Retrospective Studies
  • Sarcopenia / pathology

Substances

  • Angiotensin Receptor Antagonists
  • Anti-Arrhythmia Agents
  • Diuretics
  • Gout Suppressants
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors