White-coat uncontrolled hypertension was associated with a significantly higher risk of falls compared to normotension (RR 2.97; P=0.007) in adults aged ≥75 years.
Cohort (n=137)
No
Do different blood pressure phenotypes have distinct prognostic implications for mortality, falls, and frailty in very old subjects?
In very old subjects, blood pressure phenotypes have distinct prognostic implications, with masked uncontrolled hypertension linked to higher mortality and white-coat uncontrolled hypertension linked to an increased risk of falls.
Relative Risk: 2.97
p-value: p=0.007
Objective: Blood pressure (BP) phenotypes are associated with distinct prognoses: uncontrolled hypertension (UH) and masked uncontrolled hypertension (MUCH) carry an increased cardiovascular risk, whereas White-coat uncontrolled hypertension (WUCH) shows an intermediate or near-normotensive risk. However, these prognostic differences have been primarily established in middle-aged populations. Outcome evidence in older individuals is limited and data addressing very old populations are scarce. The aim of this study was to evaluate prognostic differences (all-cause death/hospitalization/emergency room access, fall and worsening of frailty) among BP phenotypes in elderly. Design and method: We included prospectively individuals aged >=75 years attending hypertension clinic of Istituto Auxologico Italiano between May 2022 and August 2025. At baseline, participants underwent: physical examination, office BP measurement, 24-hour ambulatory BP monitoring and multidimensional geriatric assessment to estimate frailty using the Clinical Frailty Scale (CFS). After 24 months, we estimated the proportion of mortality through health care system database in overall cohort and the proportion of any hospitalization/emergence room access, falls and worsening of CFS (increment in the score) in a smaller subset without drop-out.Results: Table 1 reports main features at baseline of the 137 participants (of 153 patients recruited) with valid ABPM measurements. The population was predominantly female (n=92), with a median age of 81 IQR 77-84 years. The BP phenotypes were 29%, 21%, 15% and 35% for CH, WCUH, MUCH and UH respectively. Regarding the outcomes, depicted in figure 1, univariate analysis showed a higher proportion of all-cause mortality in MUCH (Fisher test p-value = 0.062). Conversely, the falls was significantly more frequent in the WCUH (Fisher test p-value = 0.002). These results were confirmed in the multivariable robust Poisson regression analysis adjusting for sex, age, BMI and baseline frailty. (RR WC vs NT 2.97 p-value =0.007). No significant difference was observed across the BP phenotypes for the remaining clinical and functional outcomes. Conclusions: BP phenotypes in older adults appear to be of significant clinical relevance, although their prognostic implications may differ from those observed in the general population
Croce et al. (Fri,) conducted a cohort in Hypertension (n=137). Blood pressure phenotypes (WCUH, MUCH, UH) vs. Controlled hypertension / Normotension was evaluated on All-cause death, hospitalization, emergency room access, falls, and worsening of frailty (RR 2.97, p=0.007). White-coat uncontrolled hypertension was associated with a significantly higher risk of falls compared to normotension (RR 2.97; P=0.007) in adults aged ≥75 years.