Objective: Frailty and socioeconomic disparity are increasingly recognized as important determinants of cardiovascular health in older adults. While frailty reflects cumulative biological vulnerability, social disadvantage may further influence blood pressure regulation and treatment patterns. However, population-based evidence integrating these relationships—particularly according to antihypertensive treatment status—remains limited. Design and method: We analyzed nationally representative data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016–2020. Adults aged 50 years or older with sufficient frailty index (FI) data were included. A frailty index was constructed based on 44 items, and participants were classified as robust (FI 0.25). Social disparity was assessed by using household income groups. Systolic and diastolic blood pressure were compared across frailty and income strata and further stratified by antihypertensive treatment status. Results: A total of 15,216 participants (mean age 64.4 ± 9.0 years; men 46.3%) were included in the analysis. Across the study population, increasing frailty was associated with lower systolic and diastolic blood pressure. Within the same frailty category, individuals in lower household income groups exhibited higher blood pressure levels compared with those in higher income groups. These socioeconomic gradients were most pronounced among untreated participants, who demonstrated substantial blood pressure variability across both frailty and income strata. In contrast, treated participants showed lower and more stable blood pressure distributions, with attenuated differences according to income level. Notably, untreated individuals with frailty and low income exhibited the highest blood pressure levels. Conclusions: In this nationally representative Korean data, frailty and social disparity were jointly associated with blood pressure patterns in older adults. Antihypertensive treatment appeared to mitigate socioeconomic differences in blood pressure, underscoring the importance of integrating frailty assessment and social context into hypertension management strategies for older populations.
Kim et al. (Fri,) studied this question.