期刊
INTERNATIONAL JOURNAL OF EPIDEMIOLOGY
卷 51, 期 4, 页码 1167-1177出版社
OXFORD UNIV PRESS
DOI: 10.1093/ije/dyab210
关键词
Blood pressure; frailty; ageing; cohort studies; epidemiology
资金
- Swiss National Science Foundation [P1BEP3_188171]
- University of Lausanne Hospital Centre
- University of Lausanne Department of Ambulatory Care and Community Medicine
- Canton de Vaud Department of Public Health
- City of Lausanne
- Lausanne University Faculty of Biology and Medicine
- Swiss National Foundation for Scientific Research [3247B0-120795/1]
- Fondation Medecine Sociale et Preventive, Lausanne
- Leenaards Foundation
- Loterie Romande [200608, 2018-19]
- Swiss National Science Foundation (SNF) [P1BEP3_188171] Funding Source: Swiss National Science Foundation (SNF)
A study found that there is no strong relationship between blood pressure and transitions in frailty states among older adults. This suggests that there is no well-defined optimal blood pressure level to prevent frailty in this population.
Background Low blood pressure (BP) is associated with frailty in older adults. Our aim was to explore how BP predicts transitions between frailty states. Methods We used data from the Lausanne cohort Lc65+, a population-based cohort of older adults randomly drawn from a population registry in Switzerland, in 2004, 2009 and 2014. BP was measured using a clinically validated oscillometric automated device and frailty was defined using Fried's phenotype, every 3 years. We used an illness-death discrete multi-state Markov model to estimate hazard ratios of forward and backward transitions between frailty states (outcome) in relation to BP categories (predictor of interest) with adjustment for sex, age and antihypertensive medication (other predictors). Results Among 4200 participants aged 65-70 years (58% female) at baseline, 70% were non-frail, 27% pre-frail and 2.0% frail. Over an average follow-up of 5.8 years, 2422 transitions were observed, with 1575 (65%) forward and 847 (35%) backward. Compared with systolic BP (SBP) <130 mmHg, the hazard ratio (95% confidence interval) of the transition from non-frail to pre-frail was 0.86 (0.74 to 1.00) for SBP 130-150 mmHg, and 0.89 (0.74 to 1.06) for SBP >= 150 mmHg. Compared with SBP <130 mmHg, the hazard ratio of the transition from pre-frail to frail was 0.71 (0.50 to 1.01) for SBP 130-150 mmHg, and 0.90 (0.62 to 1.32) for SBP >= 150 mmHg. Diastolic BP was a weaker predictor of forward transitions. Conclusions BP categories had no strong relationship with either forward transitions or backward transitions in frailty states. If our findings are confirmed with greater precision and assuming a causal relationship, they would suggest that there is no well-defined optimal BP level to prevent frailty among older adults.
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