Sarcopenia and risk of cardiovascular events and mortality: a meta-analysis of longitudinal observational studies

Journal article : Review

Background: The burden of cardiovascular events remains substantial with current care, highlighting the clinical importance of identifying high-risk populations. Sarcopenia, which affects 10%-27% of older adults worldwide, is modifiable but under-recognized in cardiovascular prevention because of unclear risk associations. We aimed to clarify the association between sarcopenia and cardiovascular events risk.

Methods: PubMed, Embase, and Web of Science were searched for longitudinal studies that reported on associations between sarcopenia or its related traits with cardiovascular events risk until January 2024. The primary outcome was a composite of cardiovascular events, encompassing cardiovascular diseases (such as coronary heart disease, heart failure, and stroke) and cardiovascular mortality. Data pooled using random-effects models are presented as risk ratios (RRs) and 95% confidence intervals (CIs).

Results: One hundred longitudinal studies (approximately 2.3 million participants) were included. Sarcopenia was associated with higher risk of cardiovascular events (unadjusted RR [uRR] = 1.92; 95% CI, 1.59-2.32; adjusted RR [aRR] = 1.63; 95% CI, 1.30-2.04) and cardiovascular diseases (uRR = 1.69; 95% CI, 1.39-2.04; aRR = 1.28; 95% CI, 1.12-1.46), whereas the association with cardiovascular mortality was significant only in unadjusted analyzes (uRR = 2.28; 95% CI, 1.56-3.33; aRR = 1.61; 95% CI, 0.98-2.64). Similar associations with cardiovascular events were observed for low muscle mass (uRR = 1.61; 95% CI, 1.32-1.97; aRR = 1.43; 95% CI, 1.23-1.68) and low grip strength (uRR = 2.04; 95% CI, 1.72-2.44; aRR = 1.46; 95% CI, 1.37-1.56).

Conclusions: Sarcopenia, defined using heterogeneous criteria, was associated with an increased risk of cardiovascular events later in life. These findings suggest that sarcopenia and related traits might serve as markers of elevated subsequent cardiovascular risk.

PROSPERO Registration: CRD42023400266.

Authors: Wang, N; Xiao, Y; Zhang, W; Doherty, M; Zhang, Y

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Elsevier
• Journal: Canadian Journal of Cardiology
• Publication date: 2026-03-14
• Acceptance date: 2026-02-17
• DOI: 10.1016/j.cjca.2026.02.054
• EISSN: 1916-7075
• ISSN: 0828-282X
• Pmid: 41833723
• Language: English
• Keywords: cardiovascular disease; sarcopenia; meta-analysis; mortality
• Subtype: Review