Frail by four different measures and new adverse events from lower blood pressure control in hypertensive older adults: a 2-year prospective study in The Irish Longitudinal Study on Ageing (TILDA)

Abstract Background The 2018 European Society of Cardiology/European Hypertension (ESC/ESH) guidelines for management hypertension in adults aged ≥65 years recommend a blood pressure (BP) treatment target 130–139/70–79 mmHg if tolerated [1]. Randomised controlled trials have advocated lower BP, but this may lead to adverse outcomes the frail. Yet, different operationalisations frailty exist literature [2,3]. Purpose We compared four classifications their ability predict 2-year incident (falls/fractures, syncope, transient ischaemic attack/stroke, heart attack, failure, hospitalisation, and mortality) associated with below-target BP control (<130/70 mmHg) Irish Longitudinal Study on Ageing (TILDA). Methods Data from participants treated Wave 1 (W1) was analysed. Frailty identified by Phenotype (FP) [4], Clinical Scale-classification tree (CFS) [5], 32-item self-reported Index (FI) [6], 5-item FRAIL (Fatigue, Resistance, Ambulation, Illnesses & Loss Weight) scale [7]. formulated 16 participant groups at W1 based frailty-BP combinations. Outcomes wave 2 (W2) two later were analysed binary logistic regression models adjusted age, sex, education, polypharmacy, classic orthostatic hypotension, Montreal Cognitive Assessment (MOCA) score number chronic diseases. Results Of 1920 hypertension, 1229 had full BP/FP data, 1282 BP/CFS, 1274 BP/FI, 1276 BP/FRAIL. non-frail all 4 below or above did not an increased risk any health W2. For frail target, hospitalisation W2 significantly more likely those who FP FRAIL. only mortality FI new failure falls/fractures Conclusions independently hypertensive older ESC/ESH target. However, prognostic implications. highest risks mortality), followed failure). Based our results measures considered, we that are regarded as methods choice identify when applying guideline. Models do explicitly measure comorbidities (such CFS) be less useful capture events control. Funding Acknowledgement Type funding sources: Public Institution(s). Main source(s): Department HealthIrish LifeAtlantic PhilanthropiesRoman Romero-Ortuno is funded grant Science Foundation Ireland