Arterial stiffness and frailty - A systematic review and metaanalysis

• Published in: Experimental gerontology Vol. 153; p. 111480
• Main Authors: Piotrowicz, Karolina, Gryglewska, Barbara, Grodzicki, Tomasz, Gąsowski, Jerzy
• Format: Journal Article
• Language: English
• Published: England Elsevier Inc 01.10.2021
• Subjects: Aged; Aged, 80 and over; Ankle Brachial Index; Arterial stiffness; CAVI; Cross-Sectional Studies; Frailty; Frailty - epidemiology; Humans; Metaanalysis; Pulse Wave Analysis; PWV; Vascular Stiffness; Frailty; Arterial stiffness; CAVI; PWV; Metaanalysis
• ISSN: 0531-5565; 1873-6815; 1873-6815
• DOI: 10.1016/j.exger.2021.111480

Frailty and cardiovascular disease share some of the pathophysiologic features. Our objective was to review and metaanalyse the available published evidence on the topic. We performed a comprehensive literature search for studies where pulse wave velocity (PWV) or carotid-ankle vascular index (CAVI) has been linked with frailty in older persons. Of the initial 362 abstracts, after the application of the PRISMA approach, 5 were analysed in detail. We calculated within-study and pooled standardised mean differences of aortic stiffness measures between frail and non-frail (0.62 [0.31–0.92], p < 0.0001, I2 = 88%), and pre-frail and non-frail (0.32 [0.14–0.51], p = 0.0006, I2 = 72%) groups. In two studies it was possible to extract directly or calculate based on published data the odds ratios for the concomitant frailty, associated in one case with CAVI greater by 1 m/s and in another with cfPWV >13 m/s, indicating greater probability of concomitant frailty given greater aortic stiffness. Across the studies, the prevalence of hypertension, diabetes mellitus, hyperlipidaemia, and smoking tended to increase from non-frail, to pre-frail, and frail groups, presenting a possibility of important confounding, but also a common pathophysiology. In conclusion, the pooled analysis of the published cross-sectional study results indicates a relation between aortic stiffness and frailty in older subjects. However, well designed prospective studies are needed to answer the questions of causality. •There is a relationship between cardiovascular risk factors and frailty.•The published studies are cross sectional.•In our metaanalysis, CAVI or cfPWV increase from non-frail to frail persons•Hypertension, diabetes, hyperlipidaemia or smoking may be important confounders.