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. 2019 Dec;21(12):1895-1904.
doi: 10.1111/jch.13722. Epub 2019 Oct 29.

Blood pressure in relation to frailty in older adults: A population-based study

Daniela Anker  1 , Brigitte Santos-Eggimann  2 , Marcel Zwahlen  3 , Valérie Santschi  4 , Nicolas Rodondi  1   5 , Christina Wolfson  6 , Arnaud Chiolero  1   6   7
Affiliations

Blood pressure in relation to frailty in older adults: A population-based study

Daniela Anker et al. J Clin Hypertens (Greenwich). 2019 Dec.

Abstract

In frail older adults, low blood pressure (BP) might be associated with worse health outcomes and hypertension management in this population is highly debated. Using data from a population-based study of older adults, we assessed the association between frailty and BP. We used data collected between 2014 and 2016 from 3157 participants aged between 67 and 80 years in the Lausanne cohort Lc65+. BP was measured three times at one visit, and frailty status was assessed based on Fried's phenotype model. We analyzed the cross-sectional association between BP and frailty by computing mean systolic and diastolic BP stratified by sex, age, and frailty and by fitting regression models. The average age of the participants was 73.3 (standard deviation [SD]: 4.1) years, and 59.1% were women. 34.1% were pre-frail, and 3.3% were frail. Mean BP was 135.1/76.3 mm Hg (SD 18.5/11.0). Age- and sex-adjusted systolic BP was on average lower by 2.8 mm Hg (95% confidence interval [CI]: 1.4-4.2) and 6.7 mm Hg (95% CI: 3.2-10.3) among pre-frail and frail compared to non-frail participants. Similar differences in mean diastolic BP across frailty status were found. Upon adjustment for antihypertensive treatment, the associations between frailty status and BP did not change substantially. Frail individuals had a substantially lower BP compared with non-frail older adults. Because low BP could be detrimental among frail older patients, our findings raise questions about hypertension management in this population and stress the need for additional evidence.

Keywords: epidemiology; frailty; hypertension in the elderly; observational; population-based.

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Conflict of interest statement

The authors report no conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of individuals targeted, invited, and finally included in our analyses. C1, sample 1 with a recruitment having started in 2004; C2, sample 2 with a recruitment having started in 2009; C3, sample 3 with a recruitment having started in 2014; N, total number of participants in the Lc65+; n, number of individuals.39
Figure 2
Figure 2
Potential causal relationships explaining the association between blood pressure (BP) and frailty (F). C, confounding factor
See this image and copyright information in PMC

References

    1. Anker D, Santos‐Eggimann B, Santschi V, et al. Screening and treatment of hypertension in older adults: less is more? Public Health Rev. 2018;39:26. - PMC - PubMed
    1. Benetos A, Rossignol P, Cherubini A, et al. Polypharmacy in the aging patient: management of hypertension in octogenarians. JAMA. 2015;314(2):170‐180. - PubMed
    1. Musini VM, Tejani AM, Bassett K, Wright JM. Pharmacotherapy for hypertension in the elderly. Cochrane Database Syst Rev. 2009;(4 ):CD000028. - PubMed
    1. Whelton PK, Carey RM, Aronow WS, et al. ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Hypertension (Dallas, Tex: 1979). 2018;71(6):1269–1324. - PubMed
    1. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39(33):3021‐3104. - PubMed

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