Background/Aims:The fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale is a screening tool for frailty status using a simple 5-item questionnaire. The aim of this study was to evaluate the clinical feasibility and validity of the Korean version of the FRAIL (K-FRAIL) scale.Methods:Questionnaire items were translated and administered to 103 patients aged ≥ 65 years who underwent a comprehensive geriatric assessment at the Seoul National University Bundang Hospital. In this cross-sectional study, the K-FRAIL scale was compared with the domains and the multidimensional frailty index of the comprehensive geriatric assessment. We also assessed the time required to complete the scale.Results:The participants’ mean age was 76.8 years (standard deviation [SD], 6.1), and 55 (53.4%) were males. The mean overall frailty index was 0.19 (SD, 0.17). For K-FRAIL-robust, prefrail, and frail patients, the mean frailty indices were 0.09, 0.18, and 0.34, respectively (p for trend < 0.001). A higher degree of impairment in the K-FRAIL scale was associated with worse nutritional status, poor physical performance, functional dependence, and polypharmacy. The number of items with impairment in the K-FRAIL scale was positively associated with the frailty index (B = 3.73, p < 0.001). The K-FRAIL scale could differentiate vulnerability from robustness with a sensitivity of 0.90 and a specificity of 0.33. Of all patients, 75 (72.8%) completed the K-FRAIL scale within < 3 minutes.Conclusions:The K-FRAIL scale is correlated with the frailty index and is a simple tool to screen for frailty in a clinical setting.

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mbulatory 24-h blood pressure (BP) is superior to office BP in relation to advanced hypertensive target organ damage and cardiovascular outcome. 1,2 Furthermore, it has been found that BP variability is associated with organ damage independently on the 24-h mean BP values. 3 In addition, the 24-h BP standard deviation (SD), which is a BP variability index, has been shown to be related to the progression of organ damage over the years. 4,5 It has repeatedly been shown that this phenomenon may have clinical relevance because hypertensive patients with similar 24-h mean BP values have a greater comprehensive score for organ damage when their BP variability is greater. Circulation Journal Vol.72, February 2008So, the identification of increased BP variability by ambulatory monitoring may be one way of detecting the high-risk subject among hypertensive patients.However, the exact mechanisms underlying the link between BP variability and cardiovascular risk are, as yet, unclear. Various mechanisms may be involved in the association between BP variability and cardiovascular disease. In addition to augmented mechanical stress on the cardiovascular system, increased variability of blood flow by augmented BP variability increases sheer stress on endothelial cells. 6,7 Sheer stress-induced platelet activation and subsequent hypercoagulability may lead to cardiovascular events. Neurohumoral activation, which is increased in those with increased BP variability, may also increase the risk for cardiovascular disease.One of the mechanisms explaining the relationship between BP variability and target organ damage is inflammatory response. There is some experimental evidence suggesting that elevated BP and BP variability may promote endothelial expression of cytokines and stimulate inflammation. 8 However, the exact association between BP variability and inflammation in hypertensive subjects has not yet been evaluated. We designed this study to investigate the link between BP variability and inflammation in hypertensive patients. Background Blood pressure (BP) variability has been reported to be associated with hypertensive target organ damage and cardiovascular events. However, the exact mechanism linking BP variability and organ damage is uncertain. This study was designed to investigate the association between BP variability and inflammatory marker in hypertensive patients. Methods and ResultsFifty-two hypertensive patients (28 men, 55.9±1.5 years) completed 24-h ambulatory BP monitoring. Inflammatory markers were evaluated by measuring plasma levels of interleukin (IL)-6, tumor necrosis factor (TNF)-by enzyme-linked immunosorbent assay and high sensitive C-reactive protein (hs-CRP) by particle-enhanced light-scattering immunoassay. BP variability was obtained by calculating within-subject standard deviation (SD) and coefficient of variation of BP. Subjects were grouped into tertiles according to IL-6, TNF-, and hs-CRP levels. A significant association between ambulatory BP and TNF-level was identified (P for trend =0.011). In...