Physical Fitness, Body Composition, and Metabolic Syndrome in Aging: Implications for Hypertension Risk, Target Organ Damage, and Cardiometabolic Comorbidities

Aging is associated with marked physiological adaptations, notably alterations in body composition such as progressive skeletal muscle loss, dynapenia, and the disproportionate accumulation of visceral and ectopic adiposity. Concurrently, age-related declines in muscular strength and cardiorespiratory fitness exacerbate metabolic dysfunction, creating an environment characterized by systemic inflammation, insulin resistance, arterial stiffness, and autonomic imbalance. When compounded by metabolic syndrome, these functional and phenotypic shifts significantly increase both the incidence and severity of hypertension in middle-aged and older populations, as well as the downstream risk of hypertension-related target organ damage, including left ventricular hypertrophy, chronic kidney disease, and cerebrovascular events, and cardiometabolic comorbidities such as type 2 diabetes. While clinical links among adiposity, metabolic disease, and elevated blood pressure are widely recognized, critical questions remain regarding how specific body composition phenotypes and physical fitness components interact to modulate hemodynamic regulation, vascular aging trajectories, and the long-term management of hypertension’s consequences and comorbid conditions.This Research Topic aims to advance our understanding of how changes in body composition and physical fitness intersect with metabolic syndrome to influence not only hypertension risk but also the progression, management, and consequences of hypertension in aging cohorts, including its target organ damage, related cardiovascular events, and key comorbidities such as diabetes. By integrating epidemiological analyses, physiological mechanisms, and clinical intervention trials, this collection seeks to identify actionable biomarkers, clarify pathophysiological pathways, and establish evidence-based non-pharmacological strategies for both prevention and management. In particular, we aim to address how preserving skeletal muscle mass and functional capacity can counteract metabolic decline, alleviate vascular stiffness, optimize blood pressure control, and mitigate the burden of hypertension-related organ damage and comorbid metabolic disease in older adults.To gather further insights into the complex relationships among functional capacity, body composition, and cardiometabolic health in aging populations, we welcome articles addressing, but not limited to, the following themes:• Associations between cardiorespiratory fitness, muscular strength (e.g., relative handgrip strength), and blood pressure regulation in older adults• The impact of sarcopenia, sarcopenic obesity, visceral adiposity, and muscle quality on vascular compliance, arterial stiffness, and incident hypertension• Shared pathophysiological mechanisms linking metabolic syndrome, chronic low-grade inflammation, adipokine/myokine signaling, and hypertensive vascular remodeling• Physical fitness and body composition as determinants of hypertension-related target organ damage, including left ventricular hypertrophy, chronic kidney disease, and cerebrovascular and cardiovascular events• Interactions between hypertension and its major comorbidities, particularly type 2 diabetes and insulin resistance, and the role of physical fitness and body composition in their joint management• Efficacy of targeted exercise modalities (progressive resistance training, aerobic protocols, and multicomponent regimens) on 24-hour ambulatory blood pressure, cardiometabolic risk profiles, and prevention/management of hypertension-related complications• Personalized physical activity interventions, remote/digital exercise programs, and rehabilitation strategies tailored for aging populations with hypertension and its comorbidities• Longitudinal cohort studies evaluating the joint influence of physical fitness and metabolic health on cardiovascular outcomes, target organ damage, and comorbidity trajectories across the aging lifespanWe welcome original research, systematic reviews, meta-analyses, clinical trials, and brief research reports from researchers in cardiovascular medicine, exercise physiology, gerontology, endocrinology, nephrology, and metabolic health. Topic editors: Junga Lee, Marco Alfonso Perrone Source: https://www.frontiersin.org/research-topics/86317/physical-fitness-body-composition-and-metabolic-syndrome-in-aging-implications-for-hypertension-risk-target-organ-damage-and-cardiometabolic-comorbidities