JS-HR-6: CONSIDERING FRAILTY AND EXERCISE FOR MANAGEMENT OF HYPERTENSION AND HYPERTENSIVE ORGAN DAMAGE

Abstract

Frailty is defined as physiological decline and a state of vulnerability to stress and results in adverse health outcomes. It consists of multiple domains such as physical, social, and psychological factors. Cognitive decline is one of the factors concerning frailty, and blood pressure (BP) control reduced dementia or cognitive decline significantly in meta-analysis. However, in elderly population above 80 years, positive effect of antihypertensive therapy for preventing dementia was not proved. In the latest study in hypertension research, meta-analysis of prevalence of mild cognitive impairment (MCI) among hypertensive patients were conducted. Overall prevalence of MCI was 30% in a sample of 47179 patients. Another study which prospectively followed elderly hypertensive patients for 41 months, mortality rates were lowest in those with systolic blood pressure < 140mmhg with no frailty, and highest in those with systolic blood pressure < 140mmHg with frailty. Since frailty and cognitive decline is common in hypertensive patients, adequate blood pressure management in frailty patients are required. Further research accumulating scientific evidence with longitudinal data is needed for the guidance of blood pressure control in such patients. On the other hand, treatment of elderly hypertensive patients is complicated because their comorbidity, frailty, cognitive function, and social status should be taken into consideration. Individual assessment and constant follow up is imperative for the treatment of these patients. In the era of technically advanced, people are spending less active which leads to cardiovascular risks including hypertension. However, guidelines emphasize the importance of non-pharmacological strategies such as life style modification and exercise to prevent diseases. In the latest study in hypertension research, a study compared different types of exercise which is beneficial for health. As for the result, combination exercise of aerobic and resistance training was most effective at improving cardiorespiratory fitness, muscle strength BMI, fat mass, glucose, cholesterol and triglyceride. Several studies showed isometric exercise training reduced systolic blood pressure. Other study showed vascular function improved with daily exercise habits such as stair climbing.