| Background and purpose:Background: Frailty is an age-related geriatric syndrome.Its essence is a decline in physiological reserve function,resulting in a decline in the body’s ability to resist stress and an increase in vulnerability,thereby increasing the risk of various adverse health outcomes.Studies have shown that frailty has a higher incidence in elderly hypertension patients,but there are relatively few studies on the relationship between hypertension and frailty in the elderly.The lack of blood pressure management in elderly hypertensive patients with comorbid frailty has resulted in a lack of a strong evidencebased basis for blood pressure management,prognostic risk,and clinical end-stage events in this population.Purpose:the Fried score was used to evaluate the frailty state,to study the independent risk factors of frailty and elderly hypertension,to analyze the prevalence of different frailty states in elderly hypertension patients and the correlation between frailty state and various clinical indicators.The correlation between Fried score and age,creatinine,urea,systolic blood pressure,diastolic blood pressure,etc.was studied to provide a reference for the comprehensive intervention measures of elderly hypertension patients with frailty.Research subjects and methods:Research subjects: 331 inpatients diagnosed and treated in the Department of Cardiovascular Medicine and the Department of Geriatrics in the First Affiliated Hospital of Chengdu Medical College from February 2021 to December 2021 were selected,and they were divided into non-frailty group,pre-frailty group and frailty group according to the Fried frailty index.Research methods: A cross-sectional study was first used to collect general demographic data,geriatric hypertension-related data,underlying disease and medication history,clinical serum indices and transthoracic ultrasound from 331 elderly inpatients with hypertension.Then a case-control study was used to assess the study subjects for debilitation and they were divided into non-frailty group,pre-frailty group and frailty group.SPSS 26.0 software was used for statistical analysis.After judging the normality within each group and the homogeneity of variance between groups,for the variables that conform to the normal distribution and the homogeneity of variance,one-way analysis of variance was used for comparison between groups.The Kruskal–Wallis rank-sum test was used for the comparison between groups when the variables did not conform to the normal distribution or the variance was heterogeneous.The counts were tested by chi-square test.The significant factors after treatment were included in the Logistic regression analysis,and for the data that did not conform to the normal distribution,Spearman correlation coefficient was used to analyze the correlation between Fried score and clinical indicators such as age,creatinine,urea,systolic blood pressure,and diastolic blood pressure.Result:1.A total of 331 subjects were included in this study,including 166 males(50.2%)and 165 females(49.8%).In the non-frailty group,there were 36 males(45%)and 44females(55%);In the pre-frailty group,there were 64 males(55.75%)and 51 females(44.3%);In the frailty group,there were 66 males(48.5%)and 70 females(51.5%).The age of the non-frailty group was 70.5(67-74)years,the age of the pre-frailty group was72(69-78)years,and the age of the frailty group was 78(72-83)years.In this study,there were 80 cases in the non-frailty group,accounting for 24.2%;There were 115 cases in the pre-frailty group,accounting for 34.7%;There were 136 cases in the frailty group,accounting for 41.1%.In the non-frailty group,there were 52 patients(65.0%)with grade 1 hypertension,25 patients(31.3%)with grade 2 hypertension,and 3patients(3.7%)with grade 3 hypertension.In the pre-frailty group,48 patients(41.7%)had grade 1 hypertension,55 patients(47.8%)had grade 2 hypertension,and 12 patients(10.5%)had grade 3 hypertension.In the frailty group,there were 5 patients(3.7%)with grade 1 hypertension,49 patients(36.0%)with grade 2 hypertension,and 82patients(60.3%)with grade 3 hypertension.2.As to comparison of general baseline characteristics of non-frailty group,prefrailty group and frailty group,there were statistically significant differences among the three groups(P<0.05)in heart rate,systolic blood pressure,diastolic blood pressure,duration of hypertension,atrial fibrillation,cerebrovascular disease,coronary heart disease,type 2 diabetes,chronic obstructive pulmonary disease,red blood cell count,hemoglobin,albumin,creatinine,cystatin C,β2 microglobulin,estimated glomerular filtration rate(e GFR),apolipoprotein A1,apolipoprotein B to apolipoprotein A1 ratio(Aop B/Aop A1),homocysteine(Hcy),B-type natriuretic peptide(BNP),left ventricular end-diastolic diameter(LVDD),left ventricular posterior wall thickness(LVPWT),inter-ventricular septal thickness(IVST),type of medication,angiotensin-converting enzyme inhibitor/angiotensin receptor blocker(ACEI/ARB),β-receptor blockers,calcium channel blockers(CCB),diuretics,and marital status.There were statistically significant differences among the three groups(P < 0.05)in total protein,total cholesterol,apolipoprotein B,high density lipoprotein,platelet count,globulin,urea,uric acid,triglyceride,low density lipoprotein,ejection fraction(LVEF),stroke volume(SV),left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),cardiac output per minute(CO),left ventricular shortening fraction(LVFS),height,weight,body mass index(BMI),body surface area(BSA),hyperlipidemia,homocysteinemia,residence,occupation,education level,income,smoking history,and drinking history.3.The indicators with statistically significant differences were included in the univariate Logistic regression analysis,and the results showed: there were statistically significant differences between the non-frailty group and the pre-frailty group(P<0.05)in age,hypertension grade,systolic blood pressure,cerebrovascular disease,coronary heart disease,chronic obstructive pulmonary disease,type of medication,ACEI/ARB,diuretics,apolipoprotein A1,and Aop B/Aop A1;there were statistically significant differences between the non-frailty group and the frailty group(P < 0.05)in age,hypertension grade,marital status,systolic blood pressure,diastolic blood pressure,duration of hypertension,atrial fibrillation,cerebrovascular disease,coronary heart disease,type 2 diabetes,chronic obstructive pulmonary disease,type of medication,ACEI/ARB,beta receptors blockers,CCB,diuretics,red blood cell count,albumin,cystatin C,β2-microglobulin,e GFR,apolipoprotein A,Aop B/Aop A1,left ventricular end-diastolic diameter(LVDD),left ventricular posterior wall thickness(LVPWT).4.The statistically significant indicators were included in multivariate Logistic regression analysis,and after excluding related confounding factors,the results showed:there were statistically significant differences between the non-frailty group and the prefrailty group(P<0.05)in cystatin C,e GFR,apolipoprotein A1,Aop B/Aop A1,marital status,coronary heart disease and type of medication;there were statistically significant differences between the non-frailty group and the frailty group(P < 0.05)in age,Aop B/Aop A1,systolic blood pressure,left ventricular posterior wall thickness(LVPWT),marital status,types of medication,and coronary heart disease.5.In the correlation analysis between the Fried score and various clinical indicators,since the Fried score does not conform to the normal distribution,the Spearson correlation test was used.The results of the study found that Fried score was positively correlated with age,urea,creatinine,cystatin C,β2 microglobulin,Hcy,BNP,LVPWT,heart rate,systolic blood pressure,and diastolic blood pressure(P < 0.05);Fried score was negatively correlated with red blood cell count,hemoglobin,albumin,e GFR,LVDD,and apolipoprotein A1(P<0.05).Conclusion:1.In this study,there were 136 cases in the frailty group,and the frailty detection rate was 41.1%,and with the increase of age,the possibility of frailty increased.2.Age,systolic blood pressure,cystatin C were positively correlated with Fried score.3.Age,Aop B/Aop A1,systolic blood pressure,type of medication,coronary heart disease were independent influencing factors of frailty. |
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