Hypertension and frailty in older adults: a bibliometric analysis and knowledge mapping based on Web of Science,...

Hypertension and frailty frequently coexist in older adults and jointly increase the risks of falls, hospitalization, disability, and mortality. However, bibliometric evidence mapping the knowledge structure, hotspots, and trends in this field remains limited. This study aimed to characterize the intellectual landscape of hypertension and frailty research using a multi-database bibliometric approach.

English-language publications were retrieved from the Web of Science Core Collection (WoSCC), Scopus, and PubMed. Article and Review types were restricted in WoSCC and Scopus, while PubMed records were harmonized during preprocessing. Records were merged in R using bibliometrix and deduplicated mainly by DOI and title. Annual trends, countries/regions, institutions, authors, journals, and collaboration patterns were analyzed. VOSviewer and bibliometrix were used for keyword co-occurrence and institutional collaboration networks. CiteSpace, based on WoSCC data, was used for keyword clustering, citation bursts, and citation analyses.

In total, 1,853 records were retrieved from WoSCC, 5,210 from Scopus, and 1,615 from PubMed; 4,954 publications were included after cleaning. Publications were sparse from 1973 to 2000, increased after 2000, accelerated after 2010, and rose sharply after 2015, approaching 1,000 in 2023. The United States contributed the most publications (1,086; 21.9%), followed by China (542; 10.9%) and Italy (379; 7.7%). Wang Y was the most productive author, Archives of Gerontology and Geriatrics was the leading journal, and Harvard University was the most productive institution. Keyword analyses highlighted hypertension management, frailty indices, body composition, grip strength, gait speed, physical activity, and successful aging. CiteSpace identified recent citation bursts for "frailty index" and "hypertension management." The PURE study ranked first in global citations, while the SPRINT trial in adults aged ≥75 years ranked first in local citations.

Research on hypertension and frailty has grown rapidly, especially after 2015, forming a knowledge structure focused on hypertension management, frailty assessment, and functional outcomes. Future studies should address multimorbid populations, prioritize functional endpoints, and validate combined blood pressure control and function-oriented interventions in real-world settings.