ISH NIA PS 02-06 Effect of Frailty on Hypertension Prevalence, Treatment, and Control in Korean Elderly

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Abstract

Objective:

As blood pressure rises with age, the majority of the elderly have hypertension. Population of older hypertensive patients is highly heterogeneous group, and their physiological ability and vulnerability which is called frailty vary widely even in same chronological age. However, there have been few studies regarding the effect of frailty on hypertension.

Design and Method:

We analyzed the data of the fifth Korea National Health and Nutrition Examination Survey (KNHANES V-1), 2012 which contains 4363 older adults (age ≥ 65) data. We constructed a frailty index (FI) with 42-items and classified participants as robust (FI ≤ 0.2), pre-frail (0.20.35). Chi-square test and one-way analysis of variance (One-way ANOVA) were used to evaluate the association of the frailty status with prevalence, treatment and control of hypertension.

Results:

The mean age was 72.8 ± 5.52 years and 1,954 (42.9%) participants were men. In total cohort, 2795 participants (64.1%) had hypertension and 873 (20.0%) had pre-hypertension. In terms of frailty status, 2383 (54.6%), 1538 (35.3%) and 442 (10.1%) individuals were classified as robust, pre-frail and frail, respectively, and the frailty status was associated with hypertension with statistical significance (P < 0.001). In hypertensive patients, frail elderly are more likely to be treated than pre-frail or robust elderly (P < 0.001), while the proportion of patients who had been controlled was not statistically significant (P = 0.322). There was no difference in Systolic BP according to frailty status in treated patients, however, diastolic BP was lower in frail patients (72.69 mmHg) than pre-frail (73.02 mmHg) or robust (74.19 mmHg) patients (P = 0.012).

Conclusions:

The prevalence of hypertension is correlated with frailty status in the elderly and frail patients are more likely to be treated than pre-frail or robust patients. However, control rate does not differ from each other, and lower diastolic BP is more frequent in treated frail patients which can cause falls and adverse cardiovascular outcomes.

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