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Heart Health, Explained

Heart Health Explained

Muscle Mass: Can Preserving Muscles Help Prevent Heart Disease as You Age?

A study published in the January 2020 issue of the Journal of Epidemiology and Community Health found that measures of skeletal muscle mass can provide a valuable predictor of cardiovascular disease risk among people at least 45-years-old without pre-existing heart conditions. Specifically, preserving muscle mass may contribute to preventing cardiovascular disease.

Below, please find a Q&A regarding the study on muscle mass and cardiovascular disease risk.

Muscle Mass & Cardiovascular Disease Q&A

What’s the most important thing people should know about this study as it relates to their health? Are there any simple conclusions to draw?
The findings suggest that a higher skeletal muscle mass may have a protective benefit against cardiovascular disease. This means that there is likely a powerful benefit to heart health with regular resistance/strength training exercises (2x or more per week) as we enter our middle ages and older.
What is skeletal muscle mass, and what was this study seeking to determine? Has this been done before?

Skeletal muscle mass is the weight of the muscles in our body. This study out of Greece was looking to find out if a higher skeletal muscle mass was a positive factor for future cardiovascular benefits in patients currently free of cardiovascular disease.

They tested the patients and then reassessed the patients 10 years later. A study of this kind had never been done before. This is important because it eliminated the concern that cardiovascular disease had actually been the cause of a decrease in skeletal muscle mass.

What were the results?
The authors found that patients in the top third of muscle mass measurements at the beginning of the study had an 81% lower risk of a cardiovascular disease event over the following 10 years. This was after controlling for other factors that may be contributing to the development of cardiovascular disease.
Did the study reveal any differences concerning subgroups? Why were the findings different for women?

There indeed were statistically significant differences in subgroups, including those based on gender, education level and adherence to a Mediterranean diet (low in red meat and high in fruits, vegetables, whole grains, nuts, and olive oil).

The most profound separation within a subgroup was between men and women, as no benefit was found in women. This is possibly explained by the fact that the number of women with heart disease was low overall, because women develop heart disease 10 years later, on average, than men. The gender difference could be also be complicated by women having a higher number of other risk factors for heart disease.

What were the strengths and shortcomings of this study’s design and execution?

The main strength of the study was that it was the first to evaluate skeletal muscle mass over 10 years in a cardiovascular disease-free population. The study also shines a light on muscle mass as a significant factor of our heart health in our middle age years and older.

One weakness, however, would include the fact that the skeletal muscle mass analysis was only recorded once, and this attribute can certainly change at different rates as we age. Additionally, all the subjects were from the same geographic area within Greece. Ideally, we would have a more diverse sampling from different geographic populations.

What, if anything, should people and health care professionals do differently in the face of these findings? What are the challenges to addressing this issue?

The findings support our need for health programs and strategies that promote exercise more broadly. The findings also place a focus on the need to increase the protein in our diets. It has been stated that many Americans (these study subjects were Greek) take in an insufficient amount of protein, which can negatively affect skeletal muscle mass.

The challenges to addressing this issue are unfortunately many. There is a universal lack of funding for preventive medicine programs. Our population’s current inactivity rates create a significant need for focus on regular exercise that can increase our skeletal muscle mass and decrease our risk of cardiovascular disease. Hopefully, this well-designed study will help move all of us in the right direction.


Answers to your questions on timely topics in cardiac care to help make sense of research reports in the media. The series includes questions on your heart and the effect of medications, exercise, diet, and hormones.

Team Specialist

David Sabgir, MD, Cardiology, OhioHealth Health System

Q&A Editor

Teresa Caulin-Glaser, MD, FACC, FAACVPR System Vice President, Heart & Vascular Services OhioHealth Healthcare System, Columbus, Ohio

Heart Health Explained is a collaboration of Women’s Health Research at Yale and the OhioHealth Healthcare System, a nationally recognized not-for-profit organization with providers across 46 counties, offering a holistic approach to prevention, treatment and rehabilitation of heart disease. OhioHealth is staffed by physicians, psychologists, nutritionists and nurses who answer the questions of the moment on heart and vascular health.

The information provided here may help you make more informed choices. However, it is not a substitute for an individualized medical opinion or diagnosis, and everyone should always consult with their personal physicians to make decisions about their condition or treatment.