Relationship Between Frailty And Cardiovascular Risk Factors And Endpoint Events In The Elderly

ObjectivesFrailty is an important geriatric syndrome.Frailty and cardio-cerebrovascular disease may promote each other.This study aims to explore the relationship between frailty and blood pressure,hemoglobin A1 c,blood lipid levels and cardio-cerebrovascular endpoint events in the elderly.MethodsFrom September 2016 to December 2016,408 elderly patients(aged?60 years old)were selected from Fujian provincial hospital.Using grip strength and 4m gait speed to evaluate frailty.Composite endpoint events or cardio-cerebrovascular endpoint events were obtained through telephone follow-up.Composite endpoint events include all-cause death,acute myocardial infarction,hospitalization for unstable angina,hospitalization for heart failure and acute stroke.Cardio-cerebrovascular endpoint events include sudden cardiac death,acute myocardial infarction,hospitalization for unstable angina,hospitalization for heart failure and acute stroke.Binary logistic regression was used to analyze the relationship between frailty and blood pressure,hemoglobin A1 c and blood lipid levels.Kaplan-Meier survival curve and Cox proportional risk regression model were used to analyze the relationship between frailty and cardio-cerebrovascular endpoint events.Results1.The proportion of SBP?150mmHg,HbA1c?7.5% and dyslipidemia in the frailty group was higher than that in the non-frailty group,and the differences were statistically significant(all P<0.05).Binary logistic regression analysis showed that the risk of frailty in the SBP?150mmHg group was 2.071 times than that in the SBP< 150 mmHg group,the risk of frailty in the HbA1 c 7.5% group was 2.392 times that in the HbA1c<7.5% group,and the risk of frailty in the dyslipidemia group was 2.220 times that in the non-dyslipidemia group(all P<0.05).2.A total of 408 elderly patients were followed up,with a follow-up rate of 89.2% and a median follow-up time of 27.3 months.The proportion of low grip strength and the proportion of slow gait speed in the composite endpoint events group and the cardio-cerebrovascular endpoint events group were higher than those in the non-endpoint events group and the non-cardio-cerebrovascular endpoint events group(all P<0.05).3.Groups were divided according to baseline grip strength and gait speed,A1 group(normal grip strength and gait speed),A2 group(low grip strength or slow gait speed),A3 group(low grip strength and slow gait speed).There was a statistically significant differences in the proportion of composite endpoint events among the A1,A2 and A3 groups(P<0.05).And the proportion of composite endpoint events in the A3 group was significantly higher than that in the A1 group(P<0.05).There was a statistically significant difference in the proportion of cardio-cerebrovascular endpoint events among the A1,A2 and A3 groups(P < 0.05).And the proportion of cardio-cerebrovascular endpoint events in the A3 group was significantly higher than that in the A1 group(P<0.05).4.Kaplan-meier survival analysis showed that the survival rate without composite endpoint events in the normal grip strength and gait speed group was higher than that in the low grip strength and slow gait speed group(log-rank,P<0.001).The survival rate without cardio-cerebrovascular endpoint events in the normal grip strength and gait speed group was higher than that in the low grip strength and slow gait speed group(log-rank,P<0.001).5.Cox regression analysis showed that compared with the normal grip strength and gait speed group,the risk of composite endpoint events in the low grip strength or slow gait speed group increased(HR=2.934,P<0.05);and the risk of composite endpoint events in the low grip strength and slow gait speed group increased(HR=9.301,P<0.001).There was no statistically significant difference in the risk of cardio-cerebrovascular endpoint events in the normal grip strength and gait speed group compared with low grip strength or slow gait speed(HR=1.521,P=0.387).Compared with the normal grip strength and gait speed group,the risk of cardio-cerebrovascular endpoint events in the low grip strength and slow gait speed increased(HR=3.195,P<0.05).ConclusionsThe elderly frailty was correlated with blood pressure,hemoglobin A1 c and blood lipid level.The risk of composite endpoint events and cardio-cerebrovascular endpoint events was increased in elderly frailty patients,independent of blood pressure,hemoglobin A1 c,and blood lipid levels.