Systolic Blood Pressure and Mortality in Community-Dwelling Older Adults: The Role of Frailty
Key result
SBP <100 mmHg is linked to ~16% higher mortality in frail adults, reflecting U-shaped risk.
- HR 1.16
- 95% CI 1.02-1.32
- n=18,503
Why the study?
To investigate whether frailty modifies the association between systolic blood pressure and cardiovascular or all-cause mortality in community-dwelling older adults.
Does frailty modify the association between systolic blood pressure and mortality in community-dwelling older adults?
Population
18,503 community-dwelling adults aged 65 years or older in China
Comparison
Systolic blood pressure levels stratified by frailty status
Design
Prospective cohort study
Follow-up
Median 42.7 months
Authors
Discussion
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Member takes
Implication
May warrant relaxed SBP targets in frail elderly; leaves open whether frailty modifies BP goals in randomized trials.
Study Design
Type
Cohort (n=18,503)
Multicenter
Yes
Structured PICO
Does frailty modify the association between systolic blood pressure and mortality in community-dwelling older adults?
P
Population
18,503 community-dwelling older Chinese adults aged ≥65 years, followed for a median of 42.7 months to assess the association of systolic blood pressure and frailty with mortality.
E
Exposure
Systolic blood pressure levels (stratified by frailty status)
C
Comparator
Systolic blood pressure 120-130 mmHg
O
Outcome
Cardiovascular mortality and all-cause mortalityhard clinical
Main Result
Hazard Ratio: 1.16 (95% CI 1.02–1.32)
Frailty modifies the prognostic impact of systolic blood pressure in older adults, suggesting that strict BP control may be harmful in frail individuals who exhibit a U-shaped mortality risk.
Cite This Study
Chen et al. (2022) conducted a cohort in Community-dwelling older adults (n=18,503). Systolic blood pressure (SBP) vs. SBP 120-130 mmHg was evaluated on all-cause mortality (HR 1.16, 95% CI 1.02-1.32). In frail older adults, systolic blood pressure showed a U-shaped association with mortality, with increased risk for SBP <100 mmHg (HR 1.16; 95% CI 1.02-1.32) and ≥150 mmHg compared to 120-130 mmHg.