Frailty, Cardiovascular Risk, and Lipidic Goals: Understanding the Link in Primary Prevention

Introduction. Frailty is common in older adults and is associated with worse outcomes, including cardiovascular disease (CVD). However, limited data exist on its link to cardiovascular risk (CVR) in primary prevention and lipid target achievement. Objective. To assess the associations between frailty, measured by the 5-item FRAIL questionnaire, and estimated CVR, as well as LDL (cLDL) and non-HDL (cNoHDL) cholesterol goal attainment, in older adults without prior CVD. Methods. Secondary analysis of adults aged ≥60 years from the SABE Colombia study (n = 23,694). Frailty status was classified as robust, prefrail, or frail. CVR and lipid goal attainment were assessed via odds ratios (ORs) and regression models. Results: A total of 1,270 individuals were included; 22,146 were excluded because of missing CVR data, and 278 were excluded because of prior CVD. Frailty status: 48.58% robust, 48.35% prefrail, and 3.07% frail. cLDL goal achievement ranged from 0.72% to 3.93% according to the Framingham and ASCVD 2013 equations, respectively. Using the SCORE2 equation, cNoHDL goal achievement was 9.60%. Frailty was associated with a high CVR category with an OR of 5.53 (95% CI 2.05–14.89, ASCVD 2013) and a very high CVR category with an OR of 12.05 (CI 2.77–52.39, SCORE2). Frailty was not linked to lipid target attainment. Conclusions. Over half of the participants had prefrailty or frailty. Frailty was associated with a higher CVR but not with lipid goal achievement, underscoring the need for targeted interventions in this vulnerable group.