Related Experiment Video
Updated: May 6, 2026
05:53
Measuring Frailty in HIV-infected Individuals. Identification of Frail Patients is the First Step to Amelioration and Reversal of Frailty
Published on: July 24, 2013
18.6K
Effects of Intensive Blood Pressure Control in Patients With Frailty: A Post Hoc Analysis From ESPRIT
Shitian Li1, Yue Peng1, Yan Li1
1National Clinical Research Center for Cardiovascular Diseases, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Disease, Beijing, China.
Journal of the American College of Cardiology
|October 15, 2025
Summary
Intensive blood pressure control benefits high-risk hypertensive patients regardless of frailty. The intensive treatment strategy showed consistent effects on major adverse cardiovascular events and adverse events across all frailty levels in the ESPRIT trial.
Area of Science:
- Cardiology
- Geriatrics
- Clinical Trials
Background:
- Limited evidence exists on intensive blood pressure (BP) control benefits and harms in frail individuals.
- Frailty assessment is crucial for tailoring cardiovascular risk management strategies.
Purpose of the Study:
- To analyze the benefit-harm profile of intensive BP control based on frailty status within the ESPRIT trial.
- To investigate heterogeneity in treatment effects across different levels of frailty.
Main Methods:
- Post hoc analysis of the ESPRIT trial data.
- Participants categorized into nonfrail, moderately frail, and severely frail using the Rockwood cumulative deficit approach (frailty index).
- Examined effects of intensive BP-lowering treatment on major adverse cardiovascular events (MACE), all-cause death, and safety outcomes.
Main Results:
- Intensive BP control showed consistent benefits for MACE and all-cause death across all frailty levels (nonfrail, moderate, severe).
- No significant interaction was observed between frailty status and the treatment effect on MACE or all-cause death.
- Serious adverse events were more common in moderately and severely frail participants, but intensive treatment effects on safety outcomes did not differ by frailty status.
Conclusions:
- Intensive systolic BP targeting (<120 mm Hg) benefits hypertensive patients with high cardiovascular risk, irrespective of their frailty.
- The intensive treatment strategy demonstrated consistent efficacy and safety across the spectrum of frailty.
Related Concept Videos
01:25Errors occurring during blood pressure monitoring
1.3K
Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Several factors...
1.3K
01:30Heart Failure V: Medical Management
218
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
218
01:22Heart Failure VI: Adjunct Therapies
255
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
255
01:30Heart Failure VII: Nursing Interventions
416
The first step in nursing management of a patient with heart failure involves thoroughly assessing the patient's medical history.Subjective Data: Obtain the patient's medical history of coronary artery disease, hypertension, myocardial infarction, and symptoms like dyspnea, orthopnea, and paroxysmal nocturnal dyspnea.Objective Data: Conduct a physical examination to identify findings such as jugular vein distention, pulmonary crackles, tachycardia, murmurs, peripheral edema, and vital signs,...
416
01:28Hypertension IV: Drug Therapy and Lifestyle Modifications
621
Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
621
01:23Hypertension V: Nursing Management
357
The nursing management of hypertension involves accurately assessing symptoms, making a comprehensive nursing diagnosis, collaborating with patients to set goals, and implementing targeted interventions to mitigate the condition's impact and improve patient well-being.Comprehensive AssessmentThe initial step in nursing care for hypertension involves a thorough patient assessment. It includes evaluating symptoms such as headaches, dizziness, blurred vision, and previous hypertension episodes.
357