Cardiovascular risk profile and frailty in a population-based study of older British men

Abstract

BackgroundFrailty in older age is known to be associated with cardiovascular disease (CVD) risk. However, the extent to which frailty is associated with the CVD risk profile has been little studied. Our aim was to examine the associations of a range of cardiovascular risk factors with frailty and to assess whether these are independent of established CVD.MethodsCross-sectional study of a socially representative sample of 1622 surviving men aged 71–92 examined in 2010–2012 across 24 British towns, from a prospective study initiated in 1978–1980. Frailty was defined using the Fried phenotype, including weight loss, grip strength, exhaustion, slowness and low physical activity.ResultsAmong 1622 men, 303 (19%) were frail and 876 (54%) were pre-frail. Compared with non-frail, those with frailty had a higher odds of obesity (OR 2.03, 95% CI 1.38 to 2.99), high waist circumference (OR 2.30, 95% CI 1.67 to 3.17), low high-density lipoprotein-cholesterol (HDL-C) (OR 2.28, 95% CI 1.47 to 3.54) and hypertension (OR 1.79, 95% CI 1.27 to 2.54). Prevalence of these factors was also higher in those with frailty (prevalence in frail vs non-frail groups was 46% vs 31% for high waist circumference, 20% vs 11% for low HDL and 78% vs 65% for hypertension). Frail individuals had a worse cardiovascular risk profile with an increased risk of high heart rate, poor lung function (forced expiratory volume in 1 s (FEV1)), raised white cell count (WCC), poor renal function (low estimated glomerular filtration rate), low alanine transaminase and low serum sodium. Some risk factors (HDL-C, hypertension, WCC, FEV1, renal function and albumin) were also associated with being pre-frail. These associations remained when men with prevalent CVD were excluded.ConclusionsFrailty was associated with increased risk of a range of cardiovascular factors (including obesity, HDL-C, hypertension, heart rate, lung function, renal function) in older people; these associations were independent of established CVD.

Association of office-based frailty score with hypertensive end organ damage in the J-SHIPP cross-sectional study

“…Observational studies have demonstrated a significant association between frailty and cardiovascular morbidity and mortality [20,21]. A longitudinal study recently reported that pre-frailty diagnosed based on Fried's biological syndrome model criterion was also significantly associated with cardiovascular events [22].…”

Cardiovascular risk factors associated with frailty syndrome among hospitalized elderly people: a cross-sectional study

“…However, in a British prospective study, the triglyceride levels were higher among frail (12%) and pre-frail individuals (9%) than among non-frail individuals (7%), which disagrees with the results from the present study. 7 In another study among elderly individuals, slight or moderate elevations in triglyceride and LDL levels were observed. 19 Consequently, occurrences of lipid problems, among others, are risk factors for arterial coronary disease, 36 which is related to frailty.…”

“…7 In Brazil, a study conducted in 17 cities found that BMI and abdominal circumference were associated with frailty, although obesity did not present any significant association. 8 Additionally, in a study among community-living elderly people, frailty was associated with higher blood pressure, larger abdominal circumference and low blood HDL levels.…”

“…Furthermore, most of the investigations have assessed community-living elderly people. 2,3,[7][8][9] There is a gap in the literature with regard to the hospital context, especially for the Brazilian elderly population.…”

Frailty and Cardiovascular Disease

“…To further support this idea, another study done in 2015 supported frailty as an independent risk factor for various diseases along the CVD spectrum. A low HDL level was one of the parameters [50]. As a part of the Longitudinal Aging Study Amsterdam, it was described that a lower total cholesterol was related to a higher rate of decline on information-processing speed indicating, ultimately, that lower total cholesterol may be considered to be a marker of frailty and predictive of lower cognitive function in the elderly [51].…”