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Meta-Analysis
. 2018 Dec 28;8(12):e024406.
doi: 10.1136/bmjopen-2018-024406.

Hypertension and frailty: a systematic review and meta-analysis

Davide L Vetrano #  1   2 , Katie M Palmer #  3 , Lucia Galluzzo  4 , Simona Giampaoli  4 , Alessandra Marengoni  5 , Roberto Bernabei  2 , Graziano Onder  2 ; Joint Action ADVANTAGE WP4 group
Affiliations
Meta-Analysis

Hypertension and frailty: a systematic review and meta-analysis

Davide L Vetrano et al. BMJ Open. .

Abstract

Objective: To review the association between hypertension and frailty in observational studies.

Design: A systematic review of the PubMed, Web of Science and Embase databases was performed. A meta-analysis was performed if at least three studies used the same definition of frailty and a dichotomous definition of hypertension.

Setting, participants and measures: Studies providing information on the association between frailty and hypertension in adult persons, regardless of the study setting, study design or definition of hypertension and frailty were included.

Results: Among the initial 964 articles identified, 27 were included in the review. Four longitudinal studies examined the incidence of frailty according to baseline hypertension status, providing conflicting results. Twenty-three studies assessed the cross-sectional association between frailty and hypertension: 13 of them reported a significantly higher prevalence of frailty in hypertensive participants and 10 found no significant association. The pooled prevalence of hypertension in frail individuals was 72% (95% CI 66% to 79%) and the pooled prevalence of frailty in individuals with hypertension was 14% (95% CI 12% to 17%). Five studies, including a total of 7656 participants, reported estimates for the association between frailty and hypertension (pooled OR 1.33; 95% CI 0.94 to 1.89).

Conclusions: Frailty is common in persons with hypertension. Given the possible influence of frailty on the risk-benefit ratio of treatment for hypertension and its high prevalence, it is important to assess the presence of this condition in persons with hypertension.

Trial registration number: CRD42017058303.

Keywords: Hypertension; frailty.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Systematic review and meta-analysis flow chart.
Figure 2
Figure 2
Proportion of participants presenting with hypertension among those with frailty. Frailty was defined according to the Cardiovascular Health Study criteria.
Figure 3
Figure 3
Proportion of participants presenting with frailty among those with hypertension. Frailty was defined according to the Cardiovascular Health Study criteria.
Figure 4
Figure 4
Cross-sectional association of frailty with hypertension. Frailty was defined according to the Cardiovascular Health Study criteria.
See this image and copyright information in PMC

References

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