Key result
Higher blood pressure is linked to increased MI, stroke, or mortality risk regardless of frailty.
Why the study?
The optimal blood pressure target in older people according to frailty status remains uncertain, specifically in young-old adults.
Does increasing blood pressure increase the risk of myocardial infarction, stroke, or mortality in young-old adults regardless of frailty status?
Cohort (n=708,964)
Does increasing blood pressure increase the risk of myocardial infarction, stroke, or mortality in young-old adults regardless of frailty status?
Standard blood pressure targets should be applied to young-old adults regardless of physical frailty status to lower the risk of cardiovascular events and mortality.
Supports standard BP targets regardless of frailty in young-old adults; hypothesis-generating from observational data and requires RCTs before practice change.
The optimal blood pressure (BP) target in older people according to frailty status remains uncertain. This article investigates how frailty affects the association between BP and cardiovascular diseases or mortality, specifically in young-old adults. A retrospective cohort was created for 708,964 older adults with a uniform age of 66 years. The association between BP and myocardial infarction (MI), stroke, or mortality was analyzed using Cox proportional hazards models. The Timed Up and Go test (TUG) was used as a measure of physical frailty. Mean follow-up was 6.8 years, detecting 38,963 (5.5%) events. There was a linear association between increasing systolic BP (SBP) or diastolic BP (DBP) and increased risk of incident MI and stroke, compared to the reference BP (SBP, 110−119 mmHg or DBP, 80−89 mmHg). The risk patterns with high BP remained similar in each TUG group (<10, 10−14, or ≥15 s). A similar pattern of increased risks was found in those who took antihypertensive drugs and who did not, however they were more pronounced in those who did not. The findings support the need to achieve the same BP target in young-old adults with or without frailty to lower the risk of MI, stroke, and mortality.
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Chun et al. (2022) conducted a cohort in Blood pressure and frailty (n=708,964). Increasing systolic or diastolic blood pressure vs. Reference BP (SBP 110-119 mmHg or DBP 80-89 mmHg) was evaluated on Myocardial infarction, stroke, or mortality. Increasing systolic or diastolic blood pressure was linearly associated with increased risk of myocardial infarction, stroke, or mortality (5.5% overall event rate) regardless of frailty status.
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