Abstract
Frailty syndrome (FS) often coexists with many diseases of the elderly, including arterial hypertension, and may affect the disease course and adherence to therapeutic recommendations. This study aimed to evaluate the relationship between frailty and adherence to therapeutic recommendations in elderly hypertensive patients. The study included 259 patients hospitalized between January 2019 and November 2020 due to exacerbation of hypertension symptoms. Medical records were used to obtain basic sociodemographic and clinical data. The study was based on the Tilburg Frailty Indicator (TFI) and the Hill–Bone Scale (HBCS). The obtained data were analyzed within a cross-sectional design. The mean frailty score indicated by the TFI questionnaire was 7.09 ± 3.73. The most prominent FS component was associated with the physical domain (4.24 ± 2.54). The mean overall adherence measured with the HBCS was 20.51 ± 3.72. The linear regression model testing the Hill–Bone “reduced sodium intake” score against the TFI domains showed no relationships between the variables. Another regression model for the Hill–Bone “appointment-keeping” subscale indicated significant predictors for physical and social TFI domains (p = 0.002 and p < 0.0001, respectively). For the Hill–Bone “taking antihypertensive drugs” variable, the regression model found significant relationships with all TFI domains: physical (p < 0.0001), psychological (p = 0.003) and social (p < 0.0001). Our study suggests that frailty in patients with arterial hypertension can negatively impact their adherence to therapeutic recommendations.
Highlights
In 2015, the number of patients with hypertension reached 1.13 billion globally, with more than 150 million cases in Central and Eastern Europe
Criteria for exclusion from the study: hypertension lasting less than 12 months; age ≤65 years; hypertension treated only with nonpharmacological methods; no patient consent to participate in the study
(84.6%), earned a monthly income ≤ 1500 PLN/month (61.4%), had stage-2 hypertension based on the AHA (American Heart Association) classification (72.2%), and were diagnosed with diabetes (54.4%)
Summary
In 2015, the number of patients with hypertension reached 1.13 billion globally, with more than 150 million cases in Central and Eastern Europe. There are two effective strategies for treating hypertension: lifestyle modification and treatment through pharmacotherapy. Health-seeking behaviors may reduce the risk of cardiovascular incidents; most patients still require pharmacotherapy despite nonpharmacological recommendation [1,4,5]. Effective lifestyle changes may be sufficient to delay or prevent the initiation of antihypertensive pharmacotherapy in patients with first-degree hypertension, and can increase the effectiveness of ongoing drug therapy. The main limitation of nonpharmacological recommendations is their poor long-term adherence [6,7]
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