Low BP a warning sign for frailty in older adults

Older adults with low blood pressure (BP) appear to have a 40-percent higher risk of frailty compared with those who have normal BP levels, according to a recent study.

Researchers conducted a secondary analysis of data from the Multidomain Alzheimer Preventive Trial (MAPT). They identified 1,394 nonfrail community-dwelling participants aged ≥70 years and followed up for 5 years.

The participants underwent BP measurement once at baseline in a lying position using a validated electronic device. High BP was defined as systolic BP ≥140 mm Hg and/or diastolic BP ≥90 mm Hg, and low BP as systolic BP ≤110 mm Hg and/or diastolic BP ≤70 mm Hg. BP-lowering drug use was also evaluated at baseline and classified according to the Anatomical Therapeutic Chemical code.

The primary outcome of incident frailty over 5 years, assessed using the Fried phenotype, was more common among participants with low BP vs high BP and those who were on ≥2 vs fewer BP-lowering medications.

Cox proportional hazards analysis confirmed that low BP was related to a greater risk of frailty (hazard ratio [HR], 1.43, 95 percent confidence interval [CI], 1.07–1.92; p=0.02). The estimate was obtained after controlling for age, sex, education, BP-lowering drug use, body mass index, diabetes, ischaemic heart disease, congestive heart failure, atrial fibrillation, and stroke, among others.

Incident frailty showed no association with either high BP (HR, 0.84, 95 percent CI, 0.63–1.22; p=0.24) or BP-lowering medication use (HR, 1.21, 95 percent CI, 0.89–1.64; p=0.22).