Association Between the Frailty and New-Onset Atrial Fibrillation/Flutter Among Elderly Hypertensive Patients

Hang, Fei; Chen, Jieruo; Wang, Zefeng; Yan, Jiafu; Wu, Yongquan

doi:10.3389/fcvm.2022.881946

Cited by 5 publications

(5 citation statements)

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“…A recently published cohort study from AHA by Orkaby et al did not show a statistically significant relationship between frailty and AFIB [ 22 ]. In contrast, another study by Hang et al showed a statistically significant relationship between frailty and first-onset AFIB in patients with arterial hypertension [ 23 ]. The degree of frailty in the elderly and the development of AFIB share common pathophysiological mechanisms such as a strong inflammatory response, poor immune function, and neurological damage.…”

Section: Discussionmentioning

confidence: 95%

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Association Between Chronic Diseases and Frailty in a Sample of Older Greek Inpatients

Kyvetos,

Kyritsi,

Vrettos

et al. 2024

Cureus

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Introduction: Previous reports have associated frailty with the existence of various chronic diseases. Especially for cardiovascular diseases, this relationship seems to be bidirectional as common pathophysiological mechanisms lead to the progression of both diseases and frailty. The study aimed to examine the relationship between chronic diseases and frailty in a sample of older Greek inpatients Methodology: In 457 consecutively admitted older patients (226, 49.5% females), the median age was 82 years (interquartile range [IQR] 75-89), and demographic factors, medical history, cause of admission, and the degree of frailty assessed with the Clinical Frailty Scale were recorded. The level of frailty was calculated for the pre-hospital status of the patients. Parametric tests and logistic regression analysis were applied to identify diseases independently associated with frailty. Results: Using the scale, 277 patients (60.6%) were classified as frail and 180 as non-frail (39.4%). In univariate analysis, frail patients were more likely to have respiratory disease, dementia, Parkinson's disease, chronic kidney disease (CKD), atrial fibrillation (AFIB), neoplastic disease, depression, stroke, heart failure (HF), and coronary artery disease. In binomial regression analysis, the diseases that were statistically significantly associated with frailty were respiratory diseases ( P = 0.009, odds ratio [OR] = 2.081, 95% confidence interval [CI] 1.198-3.615), dementia ( P ≤ 0.001, OR = 20.326, 95% CI 8.354-49.459), Parkinson's disease ( P = 0.049, OR = 3.920, 95% CI 1.005-15.295), CKD ( P = 0.018, OR = 2.542, 95% CI 1.172-5.512), AFIB ( P = 0.017, OR = 1.863, 95% CI 1.118-3.103), HF ( P = 0.002, OR = 2.411, 95% CI 1.389-4.185), and coronary artery disease ( P = 0.004, OR = 2.434, 95% CI 1.324-4.475). Conclusions: Among diseases independently associated with frailty, chronic diseases such as respiratory diseases, dementia, Parkinson's disease, CKD, and cardiovascular diseases (AFIB, HF, and coronary heart disease) have an important role. Recognizing the diseases that are highly related to frailty may contribute, by their optimal management, to delaying the progression or even reversing frailty in a large proportion of the elderly.

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Section: Discussionmentioning

confidence: 95%

“…showed a statistically significant relationship between frailty and first-onset AFIB in patients with arterial hypertension [23]. The degree of frailty in the elderly and the development of AFIB share common pathophysiological mechanisms such as a strong inflammatory response, poor immune function, and neurological damage.…”

Section: Discussionmentioning

confidence: 97%

Association Between Chronic Diseases and Frailty in a Sample of Older Greek Inpatients

Kyvetos,

Kyritsi,

Vrettos

et al. 2024

Cureus

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“…Frailty as a syndrome of reduced physical capabilities and enhanced vulnerability is a common phenomenon among older adults diagnosed with AF. On the one hand, frail patients are at higher risk for new-onset AF and on the other hand, frail patients already diagnosed with AF are at higher risk for all-cause death, ischemic stroke, and bleeding [ 11 , 12 ]. In addition to that, frail patients were less likely to be treated with oral anticoagulants, which might increase the risk of further thromboembolic complications [ 44 ].…”

Section: Discussionmentioning

confidence: 99%

“…Frailty, as a syndrome that increases with age causes reduced physical capabilities and due to its relationship to AF, is an important component of current research. Frail patients are more prone to new-onset AF and those with pre-existing AF are at increased risk for serious adverse outcome events such as thromboembolic complications (ischemic stroke), bleeding, and all-cause death [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Arrhythmias among Older Adults Receiving Comprehensive Geriatric Care: Prevalence and Associated Factors

Meyer,

Arnold,

Stein

et al. 2024

Clinics and Practice

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Background: Cardiovascular diseases and arrhythmias are medical conditions that increase with age and are associated with significant morbidities and mortality. The aim of the present study was to investigate the prevalence of arrhythmias and clinical associations in the collective of older adults receiving comprehensive geriatric care (CGC). Methods: Holter ECG monitoring (HECG) of older patients hospitalized for CGC was analyzed. The prevalence of arrhythmias and the associations between the presence of arrhythmias, patients’ characteristics and the functional status regarding basic activities of daily living (assessed by the Barthel index (BI)), walking ability (assessed by the timed up and go test (TUG)), and balance and gait (assessed by the Tinetti balance and gait test (TBGT)) were examined. Results: In the presented study, 626 patients were included (mean age: 83.9 ± 6.6 years, 67.7% were female). The most common arrhythmias detected in HECG were premature ventricular contractions (87.2%), premature atrial contractions (71.7%), and atrial fibrillation (22.7%). Atrial flutter was found in 1.0%, paroxysmal supraventricular tachycardia in 5.8%, non-sustained ventricular tachycardia in 12.5%, first-degree AV block in 0.8%, second-degree AV block type Mobitz I in 0.8%, second-degree AV block type Mobitz II in 0.3%, pause > 2.5 s any cause in 3.5%, and pause > 3 s any cause in 1.6% of the cases. Premature atrial contractions were associated with the female sex (74.8% vs. 65.3%, p = 0.018), whereas in male patients, the following arrhythmias were more common: premature ventricular contractions (91.6% vs. 85.1%, p = 0.029), ventricular bigeminus (8.4% vs. 3.8%, p = 0.021), and non-sustained ventricular tachycardia (17.3% vs. 10.1%, p = 0.014). Atrial fibrillation detected in HECG was more frequent in patients at high risk of falls, indicated by their TBGT score ≤ 18 (24.7% vs. 12.0%, p = 0.006), and premature ventricular contractions were more common in patients unable to walk (TUG score 5) compared to those with largely independent mobility (TUG score 1 or 2) (88.0% vs. 75.0%, p = 0.023). In a logistic regression analysis, atrial fibrillation detected in HECG was identified as a risk factor for a high risk of falls (odds ratio (OR): 2.35, 95% confidence interval (CI): 1.23–4.46). Conclusion: In our study, investigation of HECG of older adults hospitalized for CGC revealed that premature atrial contractions, premature ventricular contractions, and atrial fibrillation were the most common arrhythmias. Premature atrial contractions were found to be more frequent in female patients, while male patients were more prone to premature ventricular contractions. In the investigated population, atrial fibrillation emerged as a risk factor associated with a high risk of falls.

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“…This model was validated in another study, which showed a close relationship between frailty status and incident atrial fibrillation. 11 According to the SPRINT 36-item FI, participants were categorized as frail (FI>0.21) or not frail (FI≤0.21). Patients were divided into 4 groups according to their treatment arms (intensive or standard) and frailty status (frail or not frail).…”

Section: Study Population and Designmentioning

confidence: 99%

The Effect of Frailty on the Efficacy and Safety of Intensive Blood Pressure Control: A Post Hoc Analysis of the SPRINT Trial

Wang

Hua

et al. 2023

Circulation

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BACKGROUND: Frailty is associated with an increased risk of all-cause death and cardiovascular events. However, it is uncertain whether frailty modifies the efficacy and safety of intensive blood pressure control. METHODS: Data from SPRINT (Systolic Blood Pressure Intervention Trial) were used to construct a frailty index. Subgroup differences in intensive blood pressure control treatment effects and safety outcomes were measured on a relative and an absolute scale in patients with and without frailty (defined as a frailty index >0.21) using Cox proportional hazard models and generalized linear models, respectively. The primary outcome was a composite of myocardial infarction, acute coronary syndrome without myocardial infarction, stroke, heart failure, and cardiovascular death. RESULTS: A total of 9306 patients (mean age, 67.9±9.4 years), 2560 (26.7%) of whom had frailty, were included in our study. Over a median follow-up of 3.22 years, 561 primary outcomes were observed. Patients with frailty had a significantly higher risk of primary outcome in both the intensive and standard blood pressure control arms (adjusted hazard ratio, 2.10 [95% CI, 1.59–2.77] and 1.85 [95% CI, 1.46–2.35], respectively). Intensive treatment effects on primary and secondary outcomes were not significantly different on a relative scale (except for cardiovascular mortality [hazard ratio in patients with and without frailty, 0.91 (95% CI, 0.52–1.60) versus 0.30 (95% CI, 0.16–0.59), respectively; P interaction =0.01]) or absolute scale. There was no significant interaction between frailty and risks for serious adverse events with intensive treatment. CONCLUSIONS: Frailty status was a marker of high cardiovascular risk. Patients with frailty benefit similarly to other patients from intensive blood pressure control without an increased risk of serious adverse events.

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Association Between the Frailty and New-Onset Atrial Fibrillation/Flutter Among Elderly Hypertensive Patients

Cited by 5 publications

References 25 publications

Association Between Chronic Diseases and Frailty in a Sample of Older Greek Inpatients

Association Between Chronic Diseases and Frailty in a Sample of Older Greek Inpatients

Arrhythmias among Older Adults Receiving Comprehensive Geriatric Care: Prevalence and Associated Factors

The Effect of Frailty on the Efficacy and Safety of Intensive Blood Pressure Control: A Post Hoc Analysis of the SPRINT Trial

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