Impact of Frailty on the Relationship between Blood Pressure and Cardiovascular Diseases and Mortality in Young-Old Adults

• Published in: Journal of personalized medicine Vol. 12; no. 3; p. 418
• Main Authors: Chun, Sohyun, Han, Kyungdo, Lee, Seungwoo, Cho, Mi-Hee, Jeong, Su-Min, Jung, Hee-Won, Son, Ki-Young, Shin, Dong-Wook, Lee, Sang-Chol
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 08.03.2022; MDPI
• Subjects: Age; Alcohol; Antihypertensives; Blood pressure; Body mass index; Cardiovascular diseases; Cerebral infarction; Chronic illnesses; Diabetes; Exercise; Frailty; Geriatrics; Health insurance; Hypertension; Kidney diseases; Medical screening; Mortality; Myocardial infarction; Older people; Physical fitness; Population; Precision medicine; Stroke; mortality; blood pressure; cardiovascular disease; frailty; aging; heart diseases
• ISSN: 2075-4426; 2075-4426
• DOI: 10.3390/jpm12030418

The optimal blood pressure (BP) target in older people according to frailty status remains uncertain. This article investigates how frailty affects the association between BP and cardiovascular diseases or mortality, specifically in young-old adults. A retrospective cohort was created for 708,964 older adults with a uniform age of 66 years. The association between BP and myocardial infarction (MI), stroke, or mortality was analyzed using Cox proportional hazards models. The Timed Up and Go test (TUG) was used as a measure of physical frailty. Mean follow-up was 6.8 years, detecting 38,963 (5.5%) events. There was a linear association between increasing systolic BP (SBP) or diastolic BP (DBP) and increased risk of incident MI and stroke, compared to the reference BP (SBP, 110−119 mmHg or DBP, 80−89 mmHg). The risk patterns with high BP remained similar in each TUG group (<10, 10−14, or ≥15 s). A similar pattern of increased risks was found in those who took antihypertensive drugs and who did not, however they were more pronounced in those who did not. The findings support the need to achieve the same BP target in young-old adults with or without frailty to lower the risk of MI, stroke, and mortality.