Visit-to-Visit Blood Pressure Variability and Incident Frailty in Older Adults

Author:

Rouch Laure12ORCID,De Souto Barreto Philipe12,Hanon Olivier34,Vidal Jean-Sébastien34,Amar Jacques5,Andrieu Sandrine26,Cestac Philippe12,Rolland Yves12,Vellas Bruno12,Vellas Bruno,Guyonnet Sophie,Carrié Isabelle,Brigitte Lauréane,Faisant Catherine,Lala Françoise,Delrieu Julien,Villars Hélène,Combrouze Emeline,Badufle Carole,Zueras Audrey,Andrieu Sandrine,Cantet Christelle,Morin Christophe,Van Kan Gabor Abellan,Dupuy Charlotte,Rolland Yves,Caillaud Céline,Ousset Pierre-Jean,Lala Françoise,

Affiliation:

1. Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, France

2. UMR INSERM 1295, Université Toulouse III, France

3. EA 4468, Université Paris Descartes, Sorbonne Paris Cité, France

4. Service de gériatrie, Hôpital Broca, AP-HP, Hôpitaux Universitaires Paris Centre, France

5. Service de cardiologie, CHU de Toulouse, France

6. Service d’Epidémiologie et de Santé Publique, CHU de Toulouse, France

Abstract

Abstract This study aimed to determine whether visit-to-visit blood pressure (BP) variability (BPV) is associated with incident frailty. We included 1 394 nonfrail community-dwelling participants aged ≥70 years from the Multidomain Alzheimer Preventive Trial (MAPT) who underwent repeated clinical examinations, including BP and frailty, over a 5-year follow-up period. Systolic BPV (SBPV), diastolic BPV (DBPV), mean arterial pressure variability (MAPV), and pulse pressure variability (PPV) were evaluated using standard deviation (SD), coefficient of variation (CV), average real variability, successive variation, variation independent of mean, and residual SD. Incident frailty was assessed using the Fried phenotype. Cox proportional hazards models were used for the analyses. Higher SBPV was significantly associated with greater risk of frailty (1-SD increase of CV: hazard ratio [HR] = 1.18, 95% confidence interval [CI]: 1.02–1.36) after adjustment for demographics, systolic BP, antihypertensive drugs, body mass index, diabetes, ischemic heart disease, congestive heart failure, stroke, atrial fibrillation, MAPT randomization group, and frailty status. Similar results were observed with all indicators of variability. Higher PPV was associated with a greater risk of developing frailty over time (1-SD increase of CV: HR = 1.17, 95% CI: 1.01–1.35). DBPV and MAPV were not significantly associated with incident frailty. Higher SBPV and PPV were associated with greater risk of incident frailty. Our findings support the concept of BP physiological dysregulation underlying the frail state and suggest that BP instability could be an early marker of frailty.

Funder

University Hospital Center of Toulouse

University of Toulouse III

Publisher

Oxford University Press (OUP)

Subject

Geriatrics and Gerontology,Aging

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