期刊
JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES
卷 76, 期 8, 页码 1369-1375出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/gerona/glab112
关键词
Blood pressure; Epidemiology; Frailty; Variability assessment; Visit-to-visit variability
资金
- Gerontopole of Toulouse
- French Ministry of Health
- Pierre Fabre Research Institute
- ExonHit Therapeutics SA
- Avid Radiopharmaceuticals Inc.
- University Hospital Center of Toulouse
- Alzheimer Prevention in Occitania and Catalonia (APOC Chair of Excellence-INSPIRE Program)
- Association Monegasque pour la Recherche sur la maladie d'Alzheimer (AMPA)
- UMR 1027 Unit INSERM-University of Toulouse III
Higher visit-to-visit blood pressure variability, especially in systolic blood pressure and pulse pressure, was significantly associated with an increased risk of incident frailty in elderly participants. Conversely, diastolic blood pressure and mean arterial pressure variability were not significantly associated with incident frailty. These findings suggest that blood pressure instability may serve as an early marker for frailty.
This study aimed to determine whether visit-to-visit blood pressure (BP) variability (BPV) is associated with incident frailty. We included 1 394 nonfrail community-dwelling participants aged >= 70 years from the Multidomain Alzheimer Preventive Trial (MAPT) who underwent repeated clinical examinations, including BP and frailty, over a 5-year follow-up period. Systolic BPV (SBPV), diastolic BPV (DBPV), mean arterial pressure variability (MAPV), and pulse pressure variability (PPV) were evaluated using standard deviation (SD), coefficient of variation (CV), average real variability, successive variation, variation independent of mean, and residual SD. Incident frailty was assessed using the Fried phenotype. Cox proportional hazards models were used for the analyses. Higher SBPV was significantly associated with greater risk of frailty (1-SD increase of CV: hazard ratio [HR] = 1.18, 95% confidence interval [CI]: 1.02-1.36) after adjustment for demographics, systolic BP, antihypertensive drugs, body mass index, diabetes, ischemic heart disease, congestive heart failure, stroke, atrial fibrillation, MAPT randomization group, and frailty status. Similar results were observed with all indicators of variability. Higher PPV was associated with a greater risk of developing frailty over time (1-SD increase of CV: HR = 1.17, 95% CI: 1.01-1.35). DBPV and MAPV were not significantly associated with incident frailty. Higher SBPV and PPV were associated with greater risk of incident frailty. Our findings support the concept of BP physiological dysregulation underlying the frail state and suggest that BP instability could be an early marker of frailty.
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