Abstract P003: Blood Pressure, Antihypertensive Drugs, And Incident Frailty: The Multidomain Alzheimer Preventive Trial

Abstract

Objectives: To examine the association of (1) high and low BP levels and (2) AH drug use with incident frailty. Study design: We conducted a secondary analysis of the Multidomain Alzheimer Preventive Trial (MAPT). We included and followed-up for 5 years 1,394 non-frail community-dwelling participants aged ≥ 70 years. Main outcome measures: High BP was defined as systolic BP ≥ 140 mmHg and/or diastolic BP ≥ 90 mmHg and low BP as systolic BP ≤ 110 mmHg and/or diastolic BP ≤ 70 mmHg. AH drugs were classified according to the Anatomical Therapeutic Chemical (ATC) code. Incident frailty was assessed using the Fried phenotype. Cox proportional hazards models were used for the analyses. Results: Low BP was associated with greater risk of frailty (HR = 1.43, 95% CI [1.07-1.92], p=0.02) after adjustment for age, sex, education, AH drug use, BMI, diabetes, ischemic heart disease, congestive heart failure, AF, stroke, MAPT randomization group, sit-to-stand chair test and pre-frailty. Participants with low BP and 2 AH drugs or more were those having the greatest risk. Neither high BP (HR = 0.84, 95% CI [0.63-1.22], p=0.24) nor AH drug use (HR = 1.21, 95% CI [0.89-1.64], p=0.22) were independently associated with incident frailty. Conclusions: Low BP could be used as a new marker for identifying older adults at higher risk of frailty. AH medications in older adults with low BP should be continuously reviewed to assure that their potential benefits outweigh potential risks.