Changes in blood pressure associated with frailty and sarcopenia in elderly outpatients with cardiometabolic diseases.

Abstract

We aimed to examine the relationship between changes in clinic blood pressure (BP) and frailty and sarcopenia in elderly outpatients with cardiometabolic disease. In 691 elderly outpatients with cardiometabolic diseases, the associations of frailty according to the modified Japanese Cardiovascular Health Study score (J-CHS) and Kihon Checklist (KCL) criteria with clinic BP were evaluated at baseline and followed up for 3 years. Among the patients (79.2 ± 6.3 years, male 35.6%), 30.4% had frailty by the J-CHS criteria and 38.0% by the KCL criteria. A J-curve relationship was observed between BP and frailty; the prevalence of frailty was the lowest in patients with systolic BP (SBP) 119.5-130.5 mmHg and in those with diastolic BP (DBP) 72.0-80.5 mmHg. Frailty by the J-CHS criteria correlated with lower DBP (OR = 0.892 per 5 mmHg increase, 95% confidence interval [CI] 0.819-0.972, P = 0.009), whereas that by the KCL criteria correlated with lower SBP (OR = 0.872 per 10 mmHg increase, 95% CI 0.785-0.969, P = 0.011) in multivariate-adjusted models. In patients with frailty by the J-CHS criteria at baseline, changes in DBP (OR = 0.921 per 1 mmHg change, 95% CI 0.851-0.996, P = 0.038) were associated with sustained frailty 1 year later. Changes in DBP were associated with progression to a slow walking speed 1 year later (OR = 0.939, 95% CI 0.883-0.999, P = 0.047). Changes in SBP (OR = 0.928, 95% CI 0.878-0.981, P = 0.008) and DBP (OR = 0.926, 95% CI 0.859-0.997, P = 0.042) were associated with progression to a weak hand grip strength 3 years later. A J-curve relationship was observed between frailty and BP, and a decline in BP was associated with progression to a slow walking speed and weak hand grip strength in elderly outpatients with cardiometabolic diseases. Geriatr Gerontol Int 2023; 23: 506-516.