Interaction between hypertension and frailty and its impact on the death risk among the elderly: a follow-up study

Abstract

Background Hypertension and frailty are often occur together and are becoming more prevalent among elderly patients .Our study analyzed the frailty status in the elderly with hypertension and the impact of its interaction on the death risk. Method Frailty index (FI) model was used to assess the frailty status in the elderly based on the baseline data conducted in 2009; and death as outcome variables collected in 2020 were analyzed. The effects of hypertension prevalence on the frailty of the elderly with age and on the mortality of were analyzed. Cox regression and Kaplan-Meier curves were applied to evaluate the influence on the risk of death. Results Ultimately, 1197 elderly people were included in the analysis, and by 2020, there were 443 deaths, with a mortality rate of 37.0% (443/1197); 593 of them had hypertension, with a prevalence rate of 49.5% (593/1197). At any age, the FI values were higher and the mortality rate was higher in the elderly with hypertension than in those without hypertension. Cox regression analysis showed that the death risk was highest in the elderly with hypertension and frailty compared to those without hypertension and frailty (HR = 1.792, P = 0.000), followed by those without hypertension but with frailty (HR = 1.484, P = 0.000), and finally those with hypertension but without frailty (HR = 1.406, P = 0.005). The results of the survival time analysis showed that the median survival time of the elderly with hypertension and frailty was the shortest at 38.98 (95%CI: 35.64–42.32) months, which was lower than that of 52.94 (95%CI: 46.61–59.27) months in those without hypertension but with frailty, 102.71 (95%CI: 98.65-106.78) months in those with hypertension but without frailty, and 127.90 (95%CI: 113.54-134.69) months in those without hypertension and frailty (Log-rank = 999.686, P = 0.000). Conclusion Frailty is common among elderly patients suffering from hypertension, and there is an increased risk of poor health outcomes among elderly patients suffering from hypertension and frailty. For elderly patients with hypertension, attention should be paid to screening and assessing frailty in hopes of identifying it early so that appropriate measures of intervention can be taken to avoid or delay the resulting adverse effects.