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Changes in blood pressure associated with frailty and sarcopenia in elderly outpatients with cardiometabolic diseases

Joji Ishikawa1, Ayumi Toba1, Yoshiaki Tamura2

  • 1Department of Cardiology, Tokyo Metropolitan Institute for Geriatrics and Gerontology, Tokyo, Japan.

Geriatrics & Gerontology International
|May 29, 2023
PubMed

Insights

In elderly patients with cardiometabolic disease, a J-curve relationship exists between blood pressure (BP) and frailty. Declining BP is linked to slower walking speed and weaker grip strength over time.

Area of Science:

  • Geriatric Medicine
  • Cardiology
  • Metabolic Disease Research

Background:

  • Frailty and sarcopenia are significant concerns in elderly individuals with cardiometabolic diseases.
  • Understanding the interplay between blood pressure (BP) and these conditions is crucial for geriatric care.
  • Previous research has not fully elucidated the longitudinal relationship between BP fluctuations and frailty progression in this population.

Purpose of the Study:

  • To investigate the association between changes in clinic blood pressure (BP) and the development or progression of frailty and sarcopenia.
  • To examine this relationship in elderly outpatients diagnosed with cardiometabolic diseases.
  • To identify specific BP thresholds or changes that may predict frailty outcomes.

Main Methods:

  • A cohort of 691 elderly outpatients with cardiometabolic diseases was assessed.
  • Frailty was evaluated using the modified Japanese Cardiovascular Health Study (J-CHS) score and Kihon Checklist (KCL) criteria.
  • Clinic BP measurements were taken at baseline and patients were followed for 3 years to assess changes in frailty and functional status.

Main Results:

  • A J-curve relationship was observed between BP and frailty, with the lowest prevalence at SBP 119.5-130.5 mmHg and DBP 72.0-80.5 mmHg.
  • Frailty correlated with lower DBP (J-CHS) and lower SBP (KCL) in multivariate models.
  • Declines in DBP were associated with sustained frailty and progression to slow walking speed. Declines in SBP and DBP were linked to progression to weak hand grip strength.

Conclusions:

  • A distinct J-curve relationship exists between blood pressure and frailty in elderly patients with cardiometabolic disease.
  • A decrease in blood pressure is significantly associated with the progression of frailty, slow walking speed, and reduced hand grip strength.
  • These findings highlight the importance of monitoring BP trends in frail elderly patients with cardiometabolic conditions.
Abstract

Keywords:
diastolic blood pressurefrailtylongitudinal observational studysarcopeniasystolic blood pressure

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