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Cardiovascular risk profile and frailty in Japanese outpatients: the Nambu Cohort Study
Mitsuteru Matsuoka1, Taku Inoue2,3, Tetsuji Shinjo4
1Matsuoka Clinic, Tomigusuku, Japan.
Insights
Older adults with a favorable cardiovascular risk profile, including normal blood pressure and cholesterol, are more likely to be frail. This suggests a link between cardiovascular health and physical decline in aging populations.
Area of Science:
- Gerontology
- Cardiovascular Medicine
- Epidemiology
Background:
- Unfavorable cardiovascular (CV) risk profiles, such as elevated systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDL-C), are known to decelerate with aging.
- The association between CV risk profiles and frailty, a state of increased vulnerability, has been underexplored in aging populations.
- Frailty is a significant concern in geriatric care, impacting health outcomes and healthcare utilization.
Purpose of the Study:
- To investigate the relationship between cardiovascular risk factors and the prevalence of frailty in an elderly outpatient cohort.
- To determine if specific CV risk factors (SBP, LDL-C, BMI) or a composite CV risk score are associated with frailty.
- To explore potential mechanisms, such as 'reverse metabolic syndrome,' linking CV health and frailty.
Main Methods:
- Cross-sectional analysis of baseline data from a prospective cohort study.
- Inclusion of 599 subjects aged 70-83 years.
- Frailty assessment using the Kihon Checklist; CV risk factors (SBP, LDL-C, BMI) were measured.
Main Results:
- Frailty was diagnosed in 37% of the participants.
- An unfavorable CV risk profile was paradoxically associated with a lower risk of frailty.
- Higher SBP (OR 0.83) and BMI (OR 1.03) showed trends towards lower frailty risk, while LDL-C (OR 0.96) did not significantly correlate.
- Having more CV risk factors within the optimal range significantly increased the odds of frailty (e.g., 3 factors: OR 4.79).
Conclusions:
- A favorable cardiovascular risk profile, characterized by optimal levels of SBP, LDL-C, and BMI, is associated with an increased risk of frailty in older adults.
- This counterintuitive finding suggests a potential 'reverse metabolic syndrome' phenomenon in frail elderly individuals.
- Further research is needed to elucidate the complex interplay between cardiovascular health, metabolic status, and frailty in aging.
Abstract:
Epidemiologic findings indicate that unfavorable cardiovascular (CV) risk profiles, such as elevated systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), and overweight, decelerate with aging. Few studies, however, have evaluated the association between the CV risk profile and frailty. We performed a cross-sectional analysis using the baseline data of a prospective cohort study. A total of 599 subjects (age, 78 [range: 70-83] years; men, 50%) were analyzed in an outpatient setting. Frailty was diagnosed in 37% of the patients according to the Kihon Checklist score. An unfavorable CV risk profile was associated with a lower risk of frailty. The adjusted odds ratios (ORs; 95% confidence interval [CI]) of each CV risk factor for frailty were as follows: SBP (each 10 mmHg increase) 0.83 (0.72-0.95), LDL-C (each 10 mg/dl increase) 0.96 (0.86-1.05), and body mass index (each 1 kg/m2 increase) 1.03 (0.97-1.10). Moreover, the total number of CV risk factors within the optimal range was significantly associated with the risk of frailty with the following ORs (95% CI): 1, 2.30 (0.75-8.69); 2, 3.22 (1.07-11.97); and 3, 4.79 (1.56-18.05) compared with patients having no risk factors within optimal levels (p for trend 0.008). Abnormal homeostasis might lead to lower levels of CV risk factors, which together result in "reverse metabolic syndrome." Our findings indicate that a favorable CV risk profile is associated with frailty.
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